Individual
MRS. TAYLOR MICHELLE ORTEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 459-2884
Mailing address
1714 TEPETATE RD, BASILE, LA 70515-3507
(337) 459-2884
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
214084
LA
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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