Individual
MISS DEIDRA NERVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 TALBOT ST, FRANKLIN, LA 70538-4120
(337) 255-6090
Mailing address
205 TALBOT ST, FRANKLIN, LA 70538-4120
(337) 255-6090
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
290995
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290995
LICENSE #
—
Enumeration date
10/23/2019
Last updated
10/23/2019
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