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NPI Code Detail

MEDICARE: MRS. LAURA MARIE HOTLE CPNP

MEDICARE: MRS. LAURA MARIE HOTLE CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner019009MO
2363LP0200XPediatric Nurse Practitioner2001019009MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528043767
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA MARIE HOTLE CPNP
Provider Business Mailing Address
First Line : 1465 S GRAND BLVD
Second Line : 01 OFFICE ROOM #2730
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-268-2700
Fax Number : 314-268-2775
Provider Business Practice Location Address
First Line : 1465 S GRAND BLVD
Second Line : 01 OFFICE ROOM #2730
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-577-5647
Fax Number : 314-268-2775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 01/18/2021

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