| NPI | 1871990614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD DWAYNE BERTRAND CEO 225-939-4841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07021) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |