| NPI | 1770858086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY EVE BASKERVILLE Manager 318-865-2578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A03220) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2012-03-20 |