Individual
AIMEE REBEKAH MULHEARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8328
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8258
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200625
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2345567
—
LA
Enumeration date
06/20/2013
Last updated
04/13/2017
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