Individual
LILLIAN CLAIRE FUNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE 250-SOUTH, MARRERO, LA 70072-3151
(504) 349-6207
Mailing address
1111 MEDICAL CENTER BLVD, SUITE 250-SOUTH, MARRERO, LA 70072-3151
(504) 349-6207
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
1-148771
AL
367A00000X
Advanced Practice Midwife
Primary
AP07687
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05777769
MEDICAID
MS
05
—
2357468
—
LA
Enumeration date
04/03/2014
Last updated
08/11/2015
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