Healthcare Provider Details

I. General information

NPI: 1114613171
Provider Name (Legal Business Name): IN AND OUT PRIMARY CARE AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15814 PROFESSIONAL PLZ
HAMMOND LA
70403-1453
US

IV. Provider business mailing address

PO BOX 667
HAMMOND LA
70404-0667
US

V. Phone/Fax

Practice location:
  • Phone: 504-323-5758
  • Fax: 504-323-5824
Mailing address:
  • Phone: 504-630-9641
  • Fax: 504-323-5758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID GUZAN JR.
Title or Position: MANAGING MEMBER
Credential:
Phone: 504-323-5758