Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 204965 | LA |
NPI | 1508950247 |
---|---|
Provider Name | Lorna M Seybolt |
First Address | New Orleans, LA 70117-8208 |
Second Address | New Orleans, LA 70117-8208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 10/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2171070 | (05) | LA |
332740YH58 | MEDICARE (01) | LA |
H46192 | (02) | ME |