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General NPI Number Information
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NPI Number | 1053794388
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Entity Type | Organization
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Legal Business Name | TOTAL HEALTHCARE ASSOCIATES LLC
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 15825 PROFESSIONAL PLZ SUITE C
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City | HAMMOND
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State | LA
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Zip | 70403-1497
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Country | US
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Telephone | 985-662-5776
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Fax | 985-662-5718
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Provider Business Mailing Address
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Address Line | 15825 PROFESSIONAL PLZ SUITE C
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City | HAMMOND
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State | LA
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Zip | 70403-1497
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Country | US
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Telephone | 985-662-5723
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Fax | 985-662-5718
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | RUBY SHEREE MILLER
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Credential | FNP
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Telephone | 985-222-0372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 261QP2300X
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP04833
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License Number State | LA
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