Individual
MYRA S VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3236 KIRKMAN ST, LAKE CHARLES, LA 70601-8640
(337) 478-6020
Mailing address
3236 KIRKMAN ST, LAKE CHARLES, LA 70601-8640
(337) 478-6020
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN14968
LA
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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