Individual
MS. ALICE JO FAUTHEREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC, FNP
Contact information
Practice address
1140 UNIVERSITY AVE., MONROE, LA 71209-1170 3183421651, 2110 JUSTICE STREET, MONROE, LA 71201
(318) 322-8811
Mailing address
801 DOWNEY LN, MONROE, LA 71201-4746
(318) 322-1732
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
45485-01456
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1684252
—
LA
Enumeration date
11/24/2006
Last updated
07/08/2007
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