| NPI | 1720734841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA MAHAFFEY Owner 337-221-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-08-31 |