Individual
AILENNE LIZET COULON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3710 PARIS RD, CHALMETTE, LA 70043-1306
(504) 278-6318
(504) 278-6317
Mailing address
360 OAK HARBOR BLVD, SLIDELL, LA 70458-5702
(985) 726-9333
(985) 726-2666
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09890
LA
363LP0200X
Pediatric Nurse Practitioner
AP09890
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2466259
—
LA
Enumeration date
03/27/2018
Last updated
05/12/2022
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