| NPI | 1093372914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET MATRICE WALDRUP-SIMPSON Sole Member 337-852-6921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2019-05-27 |