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Individual

ALICIA RUTHERFORD RESTIVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
INFIRMARY RD, BATON ROUGE, LA 70803-0001
(225) 578-5693
Mailing address
24986 ARLINGTON AVE, DENHAM SPRINGS, LA 70726-6602
(225) 667-9657

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN096234
LA
363LF0000X
Family Nurse Practitioner
AP04303
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1465861
LA
Enumeration date
03/04/2006
Last updated
08/12/2020
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