Organization
MOBILE PRACTITIONER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER LYNN BERRY NP (OWNER)
(985) 226-1118
Entity
Organization
Contact information
Practice address
4577 MILL CREEK ST, HOUMA, LA 70360-8149
(985) 226-1118
Mailing address
4577 MILL CREEK ST, HOUMA, LA 70360-8149
(985) 226-1118
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
05453
LA
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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