Organization
PRIMARY CARE AT HOME OF LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD D. STELLY (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
6425 YOUREE DR STE 290, ONE BELLEMEAD CENTER, SHREVEPORT, LA 71105-4634
(318) 219-9549
(318) 219-3211
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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