| NPI | 1184053340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE COUVILLON BRASHER Owner, Manager 318-927-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: LA 2203781980) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA APO5536) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2014-10-01 |