Organization
PINE PRAIRIE COMMUNITY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN NICOLE ROLLINS FNP-C (CEO)
(337) 599-2800
Entity
Organization
Contact information
Practice address
1121 WALNUT STREET, PINE PRAIRIE, LA 70576
(337) 599-2800
(337) 599-2210
Mailing address
PO BOX 542, PINE PRAIRIE, LA 70576-0542
(337) 599-2800
(337) 599-2210
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
LA
261QR1300X
Rural Health Clinic/Center
Primary
2203783773
LA
Other
Enumeration date
11/09/2017
Last updated
11/05/2020
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