| NPI | 1275901746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA BETH GAUTREAUX Owner 225-333-9559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2022-07-21 |