Individual
MRS. DAINELLE RENEE GORDON STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
6300 MAIN ST, ZACHARY, LA 70791-4037
(225) 658-4000
Mailing address
7889 WASHINGTON LN, GREENWELL SPRINGS, LA 70739-4572
(225) 931-1745
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
235489
LA
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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