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Organization

PEGASUS PRIMARY PROVIDERS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLENDA SHERRY PEVETO FNP (OWNER/PROVIDER)
(318) 325-6200
Entity
Organization

Contact information

Practice address
4624 CYPRESS ST STE 7, WEST MONROE, LA 71291-1348
(318) 325-6200
(318) 998-7348
Mailing address
PO BOX 2716, WEST MONROE, LA 71294-2716

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
10/19/2023
Last updated
10/19/2023
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