Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 204516 | LA |
NPI | 1033766498 |
---|---|
Provider Name | Lisa Raymond-Prinz |
First Address | Kenner, LA 70065-2489 |
Second Address | Covington, LA 70433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2019 |
Last Update Date | 30/07/2020 |