Provider Demographics
NPI:1700146503
Name:LOTTS, ROXANNE (MSN-ANP-C)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:LOTTS
Suffix:
Gender:F
Credentials:MSN-ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 ELBERON AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1324
Mailing Address - Country:US
Mailing Address - Phone:973-704-4191
Mailing Address - Fax:
Practice Address - Street 1:275 ELBERON AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-1324
Practice Address - Country:US
Practice Address - Phone:973-704-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05059700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health