Individual
MRS. TAMMY JO BAULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1905 FAIRFIELD AVE, SHREVEPORT, LA 71101
(318) 629-4729
Mailing address
1905 FAIRFIELD AVE, SHREVEPORT, LA 71101
(318) 629-4729
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP08907
LA
Other
Enumeration date
10/09/2007
Last updated
07/20/2016
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