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General NPI Number Information
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NPI Number | 1083313142
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Entity Type | Organization
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Legal Business Name | BLESSED NP, LLC
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 315 ALAMO ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7060
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Country | US
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Telephone | 337-508-2392
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Fax |
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Provider Business Mailing Address
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Address Line | 4264 GOOS FERRY ROAD
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City | LAKE CHARLES
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State | LA
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Zip | 70615-3210
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Country | US
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Telephone | 337-532-2692
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. KIMBERLY ROLAND
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Credential | APRN, FNP-C
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Telephone | 337-532-2692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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