Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Laci Renae Robertson

Individual provider Family Nurse Practitioner · NPI 1407449721

Laci Renae Robertson is a Nurse Practitioner in Fort Payne, Alabama. Graduated from University of South Alabama College of Medicine in 2020, 6 years ago. Practices with Renew Family Dermatology LLC, a 6-clinician group. Licensed in Alabama.

Years since qualifying
6
Trained at
University of South Alabama College of Medicine
Licensed in
AL
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

212 Airport Rd W
Fort Payne, AL 35968
Phone: (256) 979-1250
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1-132480 (AL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 1-132480 (AL)

Record details

NPI number1407449721
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 17, 2021
Last updated in NPPESMarch 5, 2026
Certification dateMarch 5, 2026
Mailing address212 Airport Rd W, Fort Payne, AL 35968-3335

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Renew Family Dermatology Llc — 6 clinicians
Accepts Medicare assignment Not indicated

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