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1649943937
ALEXIS BLACK
LULING, LA
NPI
1649943937
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA 221427)
Enumeration Date
2021-08-01
Last Update Date
2021-08-20
Business Address
Ms. ALEXIS BLACK CNP
1057 PAUL MAILLARD RD STE D-1900
LULING, LA 70070-4349
Phone number: 985-785-3668
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Mailing Address
Ms. ALEXIS BLACK CNP
209 E PIN OAK DR
SAINT ROSE, LA 70087-3239
Phone number: 504-554-3034
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