Individual
MRS. CANDICE COCO DESSELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
(318) 483-4090
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2713
(469) 282-2665
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN127478
LA
363LA2100X
Acute Care Nurse Practitioner
Primary
AP09177
LA
Other
Enumeration date
02/05/2017
Last updated
03/06/2017
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