Individual
DAWANA MARY VIDRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
220 S MARKET ST, OPELOUSAS, LA 70570-5140
(337) 948-0226
(337) 948-0399
Mailing address
312 COURT ST, VILLE PLATTE, LA 70586-5248
(337) 363-5525
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
840329
LA
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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