Individual
MS. JACQUELYN LEANNA COSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-AG
Contact information
Practice address
225 DUNN ST, HOUMA, LA 70360-4440
(985) 876-0300
(985) 876-5529
Mailing address
225 DUNN ST, HOUMA, LA 70360-4440
(985) 876-0300
(985) 876-5529
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP10020
LA
Other
Enumeration date
07/09/2018
Last updated
09/05/2019
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