Individual
MR. LOUIS E HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
7210 MURRAY DR, STOCKTON, CA 95210
(209) 373-2800
(209) 373-2878
Mailing address
525 E STATE ST, BATON ROUGE, LA 70802-6929
(985) 255-3776
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN140980
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP10024
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95009654
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017037465
PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER
—
01
—
AP10024
LOUISIANA STATE BOARD OF NURSING
LA
01
—
NP95009654
CALIFORNIA STATE BOARD OF NURSING
CA
01
—
RN140980
WAITING ON LICENSE FOR NP
LA
Enumeration date
05/04/2018
Last updated
09/08/2018
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