Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 215962 | LA |
NPI | 1053918425 |
---|---|
Provider Name | Catelyn Jennifer Myers |
First Address | Baton Rouge, LA 70895-4171 |
Second Address | Baton Rouge, LA 70817-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2020 |
Last Update Date | 08/10/2020 |