| Organization Name: | PELICAN PEDIATRICS, LLC |
| NPI Number: | 1184053340 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLIE COUVILLON BRASHER (OWNER, MANAGER) |
| Mailing Address: | 911 W Main St Suite C Homer |
| State: | LA US |
| Postal Code: | 710403300 |
| Phone Number: | 3189273255 |
| Fax Number: | 3189273257 |
| NPI Enumeration Date: | 11/07/2013 |
| NPI Last Update Date: | 10/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | APO5536 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |