Individual
NICOLE M JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 OPELOUSAS ST, LAKE CHARLES, LA 70601-2641
(337) 493-9983
Mailing address
2000 OPELOUSAS ST, LAKE CHARLES, LA 70601-2641
(337) 515-1838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
204515
LA
Other
Enumeration date
04/07/2019
Last updated
02/17/2023
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