Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP05970 | LA |
NPI | 1013149954 |
---|---|
Provider Name | Mr. Christopher Holmes Alexander |
First Address | Houma, LA 70361-4176 |
Second Address | Baton Rouge, LA 70809-3685 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2009 |
Last Update Date | 05/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1813915 | (05) | LA |
431142YJQD | (02) | LA |