| NPI | 1710595640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE HOWARD Sr VP Of Administrative Services 337-408-0797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2023-05-30 |