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1124325006
JEREMY PAUL PRIME
SHREVEPORT, LA
NPI
1124325006
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA AP06350)
Enumeration Date
2011-02-11
Last Update Date
2020-08-13
Business Address
JEREMY PAUL PRIME CRNA
1541 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0000
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Mailing Address
JEREMY PAUL PRIME CRNA
1512 W KIRBY PL
SHREVEPORT, LA 71103-3822
Phone number: 318-626-0287
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