Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 204042 | LA |
NPI | 1033679501 |
---|---|
Provider Name | Mrs. Laura Elizabeth Williamson |
First Address | Alexandria, LA 71301-8421 |
Second Address | Alexandria, LA 71301-8124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2019 |
Last Update Date | 21/03/2019 |