Individual
KIRBY DWAYNE HUMBLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8333 GOODWOOD BLVD # NA, BATON ROUGE, LA 70806-7744
(225) 272-0106
(225) 275-4558
Mailing address
8333 GOODWOOD BLVD # NA, BATON ROUGE, LA 70806-7744
(225) 272-0106
(225) 275-4558
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP04446
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1476641
—
LA
Enumeration date
07/01/2005
Last updated
10/23/2018
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