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General NPI Number Information
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NPI Number | 1568815108
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Entity Type | Individual
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Provider Name | ANNIE KILBURN LANCLOS FNP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 9373 BARINGER FOREMAN RD BLDG 2
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City | BATON ROUGE
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State | LA
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Zip | 70817-6200
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Country | US
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Telephone | 225-754-8888
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Fax | 225-755-2147
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Provider Business Mailing Address
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Address Line | 9373 BARINGER FOREMAN RD BLDG 2
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City | BATON ROUGE
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State | LA
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Zip | 70817-6200
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Country | US
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Telephone | 225-754-8888
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Fax | 225-755-2147
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1-151280
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License Number State | AL
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