Individual
BECKY CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10100 GOODWOOD BLVD, BATON ROUGE, LA 70815-4521
(225) 924-7707
Mailing address
10100 GOODWOOD BLVD, BATON ROUGE, LA 70815-4521
(225) 924-7707
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN108261
LA
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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