| NPI | 1124328323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE HOWARD CFO 337-991-9276 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2024-05-24 |