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General NPI Number Information
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NPI Number | 1497301709
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Entity Type | Organization
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Legal Business Name | PELICAN MEDICAL, WELLNESS, AND COSMETIC CENTER
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 6473 HWY 44 UNIT 103
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City | GONZALES
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State | LA
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Zip | 70737-8158
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Country | US
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Telephone | 225-257-1040
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Fax | 225-257-1043
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Provider Business Mailing Address
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Address Line | 6473 HIGHWAY 44 STE 103
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City | GONZALES
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State | LA
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Zip | 70737-8179
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Country | US
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Telephone | 225-257-1040
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Fax | 225-257-1043
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Authorized Official
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Title or Position | OWNER
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Name | SARAH ELIZABETH LEMOINE
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Credential | FNP-C
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Telephone | 225-505-3971
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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 |
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License Number State |
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