Individual
SAMIRORA LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1962 JULIA ST, RAYVILLE, LA 71269-5527
(318) 728-8833
Mailing address
408 FLEUR DE LIS RD, STERLINGTON, LA 71280-3357
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
237394
LA
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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