Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | AP02203 | LA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP02203 | LA |
NPI | 1003854746 |
---|---|
Provider Name | Ms. Joan P. Cardin |
First Address | Homer, LA 71040-3328 |
Second Address | Homer, LA 71040-3328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 16/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1692247 | (05) | LA |
S34688 | (02) | LA |