Individual
DODIE GORDON DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
504 W. MAIN STREET, ELIZABETH, LA 70638
(318) 634-5475
(318) 634-5476
Mailing address
PO BOX 629, OAKDALE, LA 71463-0629
(318) 634-5475
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10136
LA
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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