Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN074918 AP05274 | LA |
NPI | 1023200987 |
---|---|
Provider Name | Allyson Delaune |
First Address | Shreveport, LA 71101-4606 |
Second Address | Shreveport, LA 71115-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 27/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1014770 | (05) | LA |