Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 25802 | LA |
Y | 2081P2900X | Pain Medicine | 025802 | LA |
NPI | 1356370589 |
---|---|
Provider Name | Dr. Tulsi Nila Bice |
First Address | Baton Rouge, LA 70884-2480 |
Second Address | Baton Rouge, LA 70809-2993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 10/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1577928 | (05) | LA |
H91018 | (02) | LA |