Provider Demographics
NPI:1194967901
Name:LAMOTTE, BERNADETTE (CPNP)
Entity type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:LAMOTTE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 HILLPOINT BLVD N
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8470
Mailing Address - Country:US
Mailing Address - Phone:757-668-2250
Mailing Address - Fax:757-668-2255
Practice Address - Street 1:1009 HILLPOINT BLVD N
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8470
Practice Address - Country:US
Practice Address - Phone:757-668-2250
Practice Address - Fax:757-668-2255
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165685363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1194967901Medicaid
541778786OtherTRICARE
NC7000502Medicaid