Healthcare Provider Details

I. General information

NPI: 1295069193
Provider Name (Legal Business Name): PARTNERS IN HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N. MAIN ST.
ST. MARTINVILLE LA
70582
US

IV. Provider business mailing address

407 N. MAIN ST.
ST. MARTINVILLE LA
70582
US

V. Phone/Fax

Practice location:
  • Phone: 337-342-2641
  • Fax: 337-342-2813
Mailing address:
  • Phone: 337-342-2641
  • Fax: 337-342-2813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP04925
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP04425
License Number StateLA

VIII. Authorized Official

Name: MRS. AIMEE DUPUIS GUIDRY
Title or Position: OWNER/NURSE PRACTITIONER
Credential: NURSE PRACTITIONER
Phone: 337-342-2641