Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 120443-06430 | LA |
NPI | 1215228135 |
---|---|
Provider Name | Pamela B Cestia |
First Address | New Iberia, LA 70563-2603 |
Second Address | Houma, LA 70360-3404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2011 |
Last Update Date | 26/04/2011 |