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Organization

LIFE UNLIMITED, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAQUEL MCCORVEY FNP (FAMILY NURSE PRACTITIONER)
(337) 212-4122
Entity
Organization

Contact information

Practice address
349 MARYVIEW FARM ROAD, LAFAYETTE, LA 70507, LAFAYETTE, LA 70507
(337) 212-4122
(337) 237-2431
Mailing address
349 MARYVIEW FARM ROAD, LAFAYETTE, LA 70507, LAFAYETTE, LA 70507
(337) 212-4122

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP09649
MEDICAL LICENSE
LA
Enumeration date
01/20/2021
Last updated
01/20/2021
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