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Individual

MRS. STEPHANIE LOUISE MAGUIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
6515 COLISEUM BLVD, ALEXANDRIA, LA 71303-3735
(318) 442-9634
Mailing address
5987 STONEGATE DR, ALEXANDRIA, LA 71303-2199
(318) 820-6533

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15113
MN
363A00000X
Physician Assistant
Primary
200059
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1722995
LA
Enumeration date
07/20/2006
Last updated
12/04/2024
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