| NPI | 1346568151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN LEWIS MOORE Family Nurse Practitioner/Manager 225-733-4559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 015344) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN075293 AP03576) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |