Organization · Type 2 NPI
Kentwood Family Clinic LLC
Rural Health Clinic/Center · Kentwood, LA
NPI number
1780050294
Active
Practice location
919 Avenue G
Kentwood, LA 70444
Fax (337) 991-9288
Mailing address
1509 Dulles Dr
Lafayette, LA 70506-3718
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Rural Health Clinic/Center Primary | 261QR1300X | None listed |
| Nurse Practitioner | 363L00000X | None listed |
| Family Nurse Practitioner | 363LF0000X | None listed |
Rural Health Clinic/Center: Definition to come...
2 other providers at this address
About NPI 1780050294
Kentwood Family Clinic LLC's National Provider Identifier is 1780050294, issued on Aug 19, 2015. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Kentwood, LA. The record was last updated on Mar 2, 2020.