NPI | 1992172621 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY RENEE MANINA Nurse Practitioner 985-606-2273 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: LA AP06729) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA AP06729) |
364SF0001X Clinical Nurse Specialist, Family Health (Licence: LA AP6729) | |
Enumeration Date | 2015-08-28 |
Last Update Date | 2022-07-21 |