Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APO3489 | LA |
NPI | 1093822496 |
---|---|
Provider Name | Ava C Mcelwee |
First Address | Bossier City, LA 71111-2394 |
Second Address | Bossier City, LA 71111-2394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |