Individual
CANDICE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
895 VERRET ST, HOUMA, LA 70360-4635
(985) 200-3225
Mailing address
895 VERRET ST, HOUMA, LA 70360-4635
(985) 200-3225
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
206236
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206236
STATE LICENSE
LA
Enumeration date
06/17/2019
Last updated
06/17/2019
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