| NPI | 1053794388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBY SHEREE MILLER Nurse Practitioner/Owner 985-222-0372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP04833) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA 261QP2300X) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2017-05-04 |