Organization
NIGHTWATER HEALTH OF LOUISIANA, INC
Active
Parent organization
NIGHTWATER HEALTH, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NIGHTWATER HEALTH, INC
Authorized official
PAUL IKEMIRE MD (CMO)
(504) 717-3050
Entity
Organization
Contact information
Practice address
719 OKEEFE AVE, NEW ORLEANS, LA 70113-1906
(504) 381-4204
Mailing address
111 WATER ST STE 4, EXETER, NH 03833-2456
(504) 717-3050
(504) 617-6371
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD.205087
LSMBE
LA
Enumeration date
02/07/2022
Last updated
12/03/2022
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