Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP09669 | LA |
NPI | 1003283862 |
---|---|
Provider Name | Ms. Leontine Maxine Trought |
First Address | New Orleans, LA 70122-3048 |
Second Address | New Orleans, LA 70125-1953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2015 |
Last Update Date | 27/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2484010 | (05) | LA |
754446 | MEDICARE (01) | LA |