| NPI | 1417359928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA HOUSTON Manager 318-436-1553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 251E00000X Home Health (Licence: LA AP07583) |
| 251F00000X Home Infusion | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QP1100X Clinic/Center, Podiatric | |
| 261QP2300X Clinic/Center, Primary Care | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2021-01-26 |