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Individual

JOHN-MARIO WALTER ALTAMIRANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
2730 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5939
(337) 988-1585
(337) 981-4694
Mailing address
2730 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5939
(337) 988-1585
(337) 981-4694

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP08184
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2387022
LA
Enumeration date
03/10/2015
Last updated
01/20/2020
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