Individual
MEAGAN MARIE DISOTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PEDIATRICS (NICU), SHREVEPORT, LA 71103-4228
(318) 675-6073
Mailing address
1501 KINGS HWY, DEPARTMENT OF PEDIATRICS (NICU), SHREVEPORT, LA 71103-4228
(318) 675-6073
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
APO6273
LA
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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