| NPI | 1699058354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LYNN BRUNSON Family Nurse Practitioner 318-259-1511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP05919) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |