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Individual

MR. MICHAEL KINGMAN VAIL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3838 N CAUSEWAY BLVD, METAIRIE, LA 70002-8194
(985) 727-8012
Mailing address
604 CASEY DR, MANDEVILLE, LA 70471-6722
(985) 845-3080

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN085565
LA

Other

Enumeration date
03/31/2016
Last updated
03/31/2016
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