Healthcare Provider Details

I. General information

NPI: 1467887281
Provider Name (Legal Business Name): EULONDA SEARCY MARTIN RN, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 03/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 MACARTHUR DR SUITE 1
ALEXANDRIA LA
71301-3767
US

IV. Provider business mailing address

2007 MACARTHUR DR BLDG 7 SUITE 1
ALEXANDRIA LA
71301-3767
US

V. Phone/Fax

Practice location:
  • Phone: 318-308-8761
  • Fax: 318-448-8157
Mailing address:
  • Phone: 318-308-8761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN070286
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License NumberRN070286 LMT7322
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberRN070286 LMT7322
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: