Individual
EVA LOIS ULLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
325 W 8TH ST, DERIDDER, LA 70634-5505
(337) 463-3387
(949) 862-5301
Mailing address
2186 BALL RD, DERIDDER, LA 70634-6656
(337) 463-3766
(337) 463-3766
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06502
LA
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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