Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 022589 | LA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 022589 | LA |
NPI | 1215934377 |
---|---|
Provider Name | Elizabeth Bonfanti Curtis |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70809-3515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 22/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080139833 | RAILROAD MEDICARE (01) | LA |
1490008 | (05) | LA |
249444YJXR | MEDICARE PTAN (01) | LA |
G71350 | (02) | LA |