Individual
MS. ALEXIS BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1057 PAUL MAILLARD RD STE D-1900, LULING, LA 70070-4349
(985) 785-3668
Mailing address
209 E PIN OAK DR, SAINT ROSE, LA 70087-3239
(504) 554-3034
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
221427
LA
Other
Enumeration date
08/01/2021
Last updated
08/20/2021
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