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General NPI Number Information
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NPI Number | 1245709658
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Entity Type | Organization
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Legal Business Name | TOLEDO HEALTH, LLC
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 11340 TEXAS HWY
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City | MANY
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State | LA
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Zip | 71449
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Country | US
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Telephone | 318-315-0574
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Fax |
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Provider Business Mailing Address
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Address Line | 760 WALKERVILLE RD
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City | MANY
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State | LA
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Zip | 71449-7963
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER/FNP
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Name | MRS. MELISSA BRANCH VINES
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Credential | FNP
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Telephone | 318-315-0574
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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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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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