Organization
PRIMARY CARE & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE LABOSTRIE (MANAGER)
(404) 490-0304
Entity
Organization
Contact information
Practice address
9954 LAKE FOREST BLVD STE 10, NEW ORLEANS, LA 70127-2647
(504) 241-0105
(504) 241-0106
Mailing address
PO BOX 872713, NEW ORLEANS, LA 70187-2713
(404) 490-0304
(504) 241-0106
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP09804
LA
Other
Enumeration date
04/14/2018
Last updated
04/14/2018
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