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1568239283
PHYLLIS CAUDILL
SHREVEPORT, LA
NPI
1568239283
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner Primary Care
(Licence: MS 906229)
Enumeration Date
2023-12-04
Last Update Date
2023-12-04
Business Address
PHYLLIS CAUDILL
1860 FAIRFIELD AVE
SHREVEPORT, LA 71101-4431
Phone number: 318-642-9450
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Mailing Address
PHYLLIS CAUDILL
1860 FAIRFIELD AVE
SHREVEPORT, LA 71101-4431
Phone number: 318-642-9450
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