Individual
ANGIE JERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L-307666
Contact information
Practice address
346 BROWN RD, QUITMAN, LA 71268-4717
(318) 614-8331
Mailing address
346 BROWN RD, QUITMAN, LA 71268-4717
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-307666
LA
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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