Individual
MRS. MOLLY BROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1970 N HIGHWAY 190, COVINGTON, LA 70433
(985) 867-8585
(985) 867-3644
Mailing address
PO BOX 3370, COVINGTON, LA 70434-3370
(985) 400-5988
(985) 867-3644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10113
LA
Other
Enumeration date
07/06/2018
Last updated
07/10/2018
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