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Individual

MS. DEBRA VIDRINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1015 SANDERS, PINE PRAIRIE, LA 70576-3611
(337) 599-2212
(337) 546-0071
Mailing address
PO BOX 65205, BATON ROUGE, LA 70896-5205
(337) 546-0101
(337) 546-0071

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN039129 APO4342
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1477532
LA
Enumeration date
11/17/2006
Last updated
10/06/2009
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