Individual
LYDA CAROL GORE HIRCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
(318) 487-1122
Mailing address
402 HEYMAN LN, ALEXANDRIA, LA 71303-3433
(318) 445-1293
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP02336
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1673536
—
LA
Enumeration date
01/22/2007
Last updated
07/08/2007
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