| NPI | 1174927685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNISA LEACHMAN TAYLOR Nurse Practitioner 225-341-0478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA AP05937) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2025-05-29 |