# NIGHTWATER HEALTH OF LOUISIANA, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NIGHTWATER HEALTH, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1821742040
- **Legal business name:** NIGHTWATER HEALTH, INC
- **Authorized official:** PAUL IKEMIRE MD (CMO)
- **Authorized official phone:** (504) 717-3050

## Contact information

- **Practice address:** 719 OKEEFE AVE, NEW ORLEANS, LA 70113-1906
- **Practice address phone:** (504) 381-4204
- **Mailing address:** 111 WATER ST STE 4, EXETER, NH 03833-2456
- **Mailing address phone:** (504) 717-3050
- **Mailing address fax:** (504) 617-6371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 02/07/2022
- **Last updated:** 12/03/2022