| NPI | 1477983062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JACKSON Owner/Nurse Practitioner 337-678-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2014-03-14 |