| NPI | 1598656035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALETHIA BUSH Office Administrator 318-331-2150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| 172V00000X Community Health Worker | |
| 104100000X Social Worker | |
| 163WG0000X Registered Nurse, General Practice | |
| Enumeration Date | 2025-07-12 |
| Last Update Date | 2025-07-24 |