Individual
KATELYN LASKEY MOLDANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4105 HARVARD AVE, METAIRIE, LA 70006-2611
(000) 111-2222
Mailing address
4105 HARVARD AVE, METAIRIE, LA 70006-2611
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09203
LA
Other
Enumeration date
10/21/2016
Last updated
05/18/2017
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