NPI | 1710595640 |
---|---|
Entity Type | Organization |
Authorized Contact | NICOLE HOWARD Sr VP Of Administrative Services 337-991-9276 |
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 | 2024-09-30 |