| Organization Name: | KIDCARE LOUISIANA, LLC |
| NPI Number: | 1073903910 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATH M VEULEMAN (PRACTICE ADMINISTRATOR) |
| Mailing Address: | 2801 Fourth St Ste 2 Jonesville |
| State: | LA US |
| Postal Code: | 713432027 |
| Phone Number: | 3183399901 |
| Fax Number: | 3183399903 |
| NPI Enumeration Date: | 01/30/2015 |
| NPI Last Update Date: | 01/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP04515 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |