Individual
LORI A NETTERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 210, BATON ROUGE, LA 70808-4300
(225) 765-7163
Mailing address
101 ASBURY CIR, LAFAYETTE, LA 70503-3632
(225) 663-0166
(337) 983-2158
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP06804
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2194399
—
LA
Enumeration date
03/16/2012
Last updated
06/28/2012
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