Organization Name: | UNIQUE HEALTHCARE OPTIONS |
NPI Number: | 1174927685 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANNISA LEACHMAN STOVER (NURSE PRACTITIONER) |
Mailing Address: | 1877 Heck Young Rd Baker |
State: | LA US |
Postal Code: | 70714 |
Phone Number: | 2253410478 |
Fax Number: | |
NPI Enumeration Date: | 10/13/2014 |
NPI Last Update Date: | 02/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | AP05937 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |