Organization Name: | ALL KIDS R US |
NPI Number: | 1083737845 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY D PUCKETT (MANAGING CONSULTANT) |
Mailing Address: | 107 Contempo Ave Ste.b West Monroe |
State: | LA US |
Postal Code: | 712915311 |
Phone Number: | 3183885030 |
Fax Number: | 3183887134 |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |