| NPI | 1265671754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BAMBURG SHARP Family Nurse Practitioner Co Owner 318-397-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA RN97721APO5017) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA RN073699APO3572) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |