Organization
PELICAN URGENT CARE, MS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN JAMES KRIEGER FNP (AUTHORIZED OFFICIAL)
(504) 606-7058
Entity
Organization
Contact information
Practice address
1839 COOPER RD, PICAYUNE, MS 39466-2835
(985) 645-9000
Mailing address
1375 CORPORATE SQUARE DR, SLIDELL, LA 70458-3147
(985) 649-1152
(985) 643-9808
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
902029
MS
Other
Enumeration date
07/17/2017
Last updated
09/11/2017
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