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Individual

THERESE ANN NOVAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1717 OAK PARK BLVD FL 2, LAKE CHARLES, LA 70601-8990
(337) 494-4900
(337) 494-4707
Mailing address
PO BOX 122108 DEPT 2108, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP02313
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1180157
LA
01
AP02313
STATE LICENSE
LA
Enumeration date
03/02/2007
Last updated
02/12/2025
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