Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP09374 | LA |
NPI | 1003346768 |
---|---|
Provider Name | Leeanne Sonnier Ardoin |
First Address | Ville Platte, LA 70586-8780 |
Second Address | Ville Platte, LA 70586-8780 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2017 |
Last Update Date | 30/12/2020 |