Individual
MISS KRISTINA N VIDRINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
920 AVENUE B, MARRERO, LA 70072-3112
(504) 349-6804
(504) 349-6844
Mailing address
920 AVENUE B, MARRERO, LA 70072-3112
(504) 349-6804
(504) 349-6844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200353
LA
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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