Organization
COMMUNITY CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA BAMBURG SHARP FNP (FAMILY NURSE PRACTITIONER- CO-OWNER)
(318) 397-3636
Entity
Organization
Contact information
Practice address
5328 CYPRESS ST, WEST MONROE, LA 71291-7506
(318) 397-3636
(318) 397-3639
Mailing address
PO BOX 2069, WEST MONROE, LA 71294-2069
(318) 397-3636
(318) 397-3639
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
RN073699APO3572
LA
261QP2300X
Primary Care Clinic/Center
Primary
RN97721APO5017
LA
Other
Enumeration date
02/06/2009
Last updated
02/06/2009
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