Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP09353 | LA |
NPI | 1043355837 |
---|---|
Provider Name | Ms. Miriam Edouard |
First Address | Harvey, LA 70059-3143 |
Second Address | Gretna, LA 70056-5255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 15/08/2017 |