Individual
MRS. LISA PENA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6759
(337) 261-6795
Mailing address
414 WOODVALE AVE, LAFAYETTE, LA 70503-3434
(337) 326-0202
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
AP05930
LA
Other
Enumeration date
09/23/2009
Last updated
08/06/2021
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