Individual
MRS. JAMIE MARIE PORTACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
1809 NORTHPOINTE LN STE 102, RUSTON, LA 71270
(318) 255-3762
Mailing address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 255-3690
(318) 251-6116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN065346
LA
363LF0000X
Family Nurse Practitioner
Primary
APO5948
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1820385
—
LA
Enumeration date
08/19/2009
Last updated
06/20/2018
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