Lara S Booth, RN

Individual provider Active NPI School Registered Nurse · Georgetown, DE

NPI 1508003989 · NPPES record last updated Jan 7, 2009

Key facts

NPI
1508003989
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
L1-0037044 (DE)
Practice address
20346 Ennis Rd
Georgetown, DE 19947-4108
Phone
(302) 856-1926
NPI assigned
Jan 7, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
L1-0037044DEMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X L1-0037044 DE Yes

Addresses

Primary practice location

20346 Ennis Rd
Georgetown, DE 19947-4108

Mailing address

20346 Ennis Rd
Georgetown, DE 19947-4108
Phone (302) 856-1926

Other providers in Georgetown, DE

All providers in Georgetown, DE · School Registered Nurse in Delaware

Sources for this page

Verify at the official NPI Registry.