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Individual

YVETTE MARIE DESLATTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1015 CRESCENT AVE, LOCKPORT, LA 70374
(985) 532-1620
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
022597
LA
207Q00000X
Family Medicine Physician
Primary
MD022597
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386611036
NPI
05
1483869
LA
Enumeration date
03/01/2006
Last updated
04/30/2008
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