Individual
NIA'JA STE'VONA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
100 WOMANS WAY, BATON ROUGE, LA 70817-5100
(225) 924-8999
Mailing address
25627 BUFFWOOD ST, DENHAM SPRINGS, LA 70726-5994
(225) 305-3828
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09772
LA
Other
Enumeration date
02/04/2018
Last updated
02/04/2018
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