Individual
MRS. CHRISTINA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18261 MANCHAC PL S, PRAIRIEVILLE, LA 70769-3371
(251) 709-6139
Mailing address
18261 MANCHAC PL S, PRAIRIEVILLE, LA 70769-3371
(251) 709-6139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
129509
LA
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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