Individual
MARISSA BOTTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, APRN
Contact information
Practice address
1331 STATE ST # 340, LA PORTE, IN 46350-3112
(219) 324-0875
(219) 324-0827
Mailing address
1331 STATE ST # 340, LA PORTE, IN 46350-3112
(219) 324-0875
(219) 324-0827
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009430A
IN
Other
Enumeration date
09/27/2019
Last updated
03/19/2026
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