Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN088362-AP05949 | LA |
NPI | 1104142769 |
---|---|
Provider Name | Laura Christine Brooks |
First Address | Shreveport, LA 71101-4343 |
Second Address | Shreveport, LA 71101-4343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 26/10/2013 |