Individual
MRS. KIMBERLY F POUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
1202 S TYLER ST, COVINGTON, LA 70433-2330
(985) 898-4438
Mailing address
10041 NANTERRE CT, MADISONVILLE, LA 70447-3227
(504) 214-6507
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
203372
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104144344
—
LA
05
—
1225148737
—
LA
Enumeration date
01/24/2019
Last updated
10/12/2019
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