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Individual

ALICE EDMAISTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
4150 NELSON RD STE 2, LAKE CHARLES, LA 70605-4148
(337) 475-8949
Mailing address
PO BOX 1426, IOWA, LA 70647-1426
(337) 391-9246

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
221771
LA

Other

Enumeration date
08/11/2021
Last updated
08/11/2021
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