Healthcare Provider Details

I. General information

NPI: 1982754289
Provider Name (Legal Business Name): ADVANCED COMPREHENSIVE TESTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 NORTH BLVD SUITE 115
BATON ROUGE LA
70806-4043
US

IV. Provider business mailing address

4560 NORTH BLVD SUITE 115
BATON ROUGE LA
70806-4043
US

V. Phone/Fax

Practice location:
  • Phone: 225-927-9441
  • Fax: 225-231-7080
Mailing address:
  • Phone: 225-927-9441
  • Fax: 225-231-7080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MERCEDES C SMITH
Title or Position: CEO
Credential:
Phone: 225-927-9441