Individual
MARY INMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
1449 E BERT KOUN LOOP STE 100, SHREVEPORT, LA 71105-5680
(318) 629-0220
(318) 629-0230
Mailing address
1449 E BERT KOUN LOOP STE 100, SHREVEPORT, LA 71105-5680
(318) 629-0220
(318) 629-0230
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
207290
LA
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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