Individual
ANGELA S LETARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
107 FRONT STREET, VIDALIA, LA 71373
(318) 336-2216
(318) 336-6074
Mailing address
#12 RED FOX DRIVE, NATCHEZ, MS 39120
(601) 392-1471
(318) 336-6074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN058840
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0123703
—
MS
05
—
1181196
—
LA
Enumeration date
09/26/2006
Last updated
10/10/2012
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