Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP05195 | LA |
NPI | 1346554805 |
---|---|
Provider Name | Angela Mccain |
First Address | Lake Charles, LA 70605-4118 |
Second Address | Lake Charles, LA 70605-4118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2010 |
Last Update Date | 27/07/2010 |