Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP08268 | LA |
NPI | 1003273574 |
---|---|
Provider Name | Pamela Stanley |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70808-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2016 |
Last Update Date | 27/04/2021 |