GINA YI INTHAVONG

SHREVEPORT, LA
NPI1912579301
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: LA  221149)
Enumeration Date2021-07-14
Last Update Date2021-07-14
Business Address
GINA YI INTHAVONG Nurse Practitioner
1800 BUCKNER ST STE C120
SHREVEPORT, LA 71101-4453
Phone number: 318-227-8899
Mailing Address
GINA YI INTHAVONG Nurse Practitioner
1800 BUCKNER ST STE C120
SHREVEPORT, LA 71101-4453
Phone number: 318-227-8899
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