| NPI | 1093266629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTNEY WHITLOCK Credentialing Specialist 318-325-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 04826) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |