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Individual

REIN LILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
2730 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5939
(337) 988-1585
(337) 981-4694
Mailing address
PO BOX 4176, HOUMA, LA 70361-4176
(985) 872-5864
(985) 872-0317

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP08707
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2421841
LA
Enumeration date
03/31/2016
Last updated
06/28/2016
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