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Organization

QUALITY CARE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY LYNN BRUNSON FNP (FAMILY NURSE PRACTITIONER)
(318) 259-1511
Entity
Organization

Contact information

Practice address
103 WATTS ST, JONESBORO, LA 71251-2053
(318) 259-1511
(318) 259-9979
Mailing address
103 WATTS ST, JONESBORO, LA 71251-2053
(318) 259-1511
(318) 259-9979

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP05919
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1054453
LA
05
1807192
LA
Enumeration date
09/20/2011
Last updated
09/20/2011
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