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General NPI Number Information
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NPI Number | 1235723818
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Entity Type | Organization
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Legal Business Name | AN ANGEL AT YOUR SIDE
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 326 MINERAL RD STE 600
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City | BROUSSARD
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State | LA
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Zip | 70518-7104
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Country | US
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Telephone | 337-330-2108
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Fax | 337-330-2113
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Provider Business Mailing Address
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Address Line | 326 MINERAL RD STE 600
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City | BROUSSARD
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State | LA
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Zip | 70518-7104
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Country | US
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Telephone | 337-330-2108
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Fax | 337-330-2113
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE DNAEE LAWDINS
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Credential | CNA
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Telephone | 832-684-7394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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