Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP08769 | LA |
NPI | 1003155227 |
---|---|
Provider Name | Mrs. Hilary Gary Fincke |
First Address | Marrero, LA 70072-3173 |
Second Address | Marrero, LA 70072-3173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2013 |
Last Update Date | 15/10/2019 |