Individual
ANNA M GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 447-5500
Mailing address
PO BOX 720487, NORMAN, OK 73070-4358
(877) 485-4474
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
203749
LA
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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