Individual
MR. KHALED S QAISIEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1012 PETROLEUM PKWY, BROUSSARD, LA 70518-8020
(337) 465-4600
(337) 465-4604
Mailing address
1012 PETROLEUM PKWY, BROUSSARD, LA 70518-8020
(337) 465-4600
(337) 465-4604
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
204205
LA
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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