Individual
DR. BLANCA IVELISSE OSORIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
105 JEFFERSON ST, NATCHITOCHES, LA 71457-4350
(318) 357-2071
(318) 521-8031
Mailing address
105 JEFFERSON ST, NATCHITOCHES, LA 71457-4350
(318) 357-2071
(318) 521-8031
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
9490A
WY
2084P0800X
Psychiatry Physician
Primary
MD 206513
LA
2084P0804X
Child & Adolescent Psychiatry Physician
MD 206513
LA
2084P0804X
Child & Adolescent Psychiatry Physician
TL2329
WY
208D00000X
General Practice Physician
13847
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
234404
—
LA
01
—
361581YJR4
MEDICARE
LA
Enumeration date
12/21/2006
Last updated
01/02/2021
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