| NPI | 1659750214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE HOWARD Sr VP Of Administrative Services 337-991-9276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2024-09-30 |