Individual
MRS. MARY DIANE RABALAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
15813 PAUL VEGA MD DR STE 200, HAMMOND, LA 70403-1431
(985) 230-7650
(985) 230-7655
Mailing address
PO BOX 2668, HAMMOND, LA 70404-2668
(985) 230-7650
(985) 230-7655
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP07283
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03976556
—
MS
05
—
2374125
—
LA
Enumeration date
07/22/2013
Last updated
12/30/2022
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