Organization
PREMIER HEALTH & WELLNESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANNIE B PINO CFNP (OWNER/CFNP)
(225) 673-4900
Entity
Organization
Contact information
Practice address
17188 AIRLINE HWY STE D, PRAIRIEVILLE, LA 70769-3443
(225) 673-4900
(225) 673-3338
Mailing address
17188 AIRLINE HWY STE D, PRAIRIEVILLE, LA 70769-3443
(225) 673-4900
(225) 673-3338
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04341
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1460508
—
LA
Enumeration date
11/07/2014
Last updated
11/07/2014
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