| NPI | 1750900197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTNEY A WHITLOCK Credentialing Specialist 318-325-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-15 |