Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 665217 | TX |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP05120 | LA |
NPI | 1255393807 |
---|---|
Provider Name | Mrs. Bobbi Marino Caldwell |
First Address | Lafayette, LA 70508-5625 |
Second Address | Lafayette, LA 70503-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 31/10/2016 |