Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 5452 | LA |
NPI | 1023108206 |
---|---|
Provider Name | Dr. Leneise Cheri Lynn |
First Address | Hammond, LA 70401 |
Second Address | Baton Rouge, LA 70815-4081 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 17/01/2012 |