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General NPI Number Information
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NPI Number | 1679155121
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH CARE, LLC
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Dates
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Enumeration Date | 04/24/2021
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 913 S COLLEGE RD STE 101
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City | LAFAYETTE
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State | LA
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Zip | 70503-3061
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Country | US
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Telephone | 337-967-3016
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Fax |
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Provider Business Mailing Address
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Address Line | 406 VALLEY VW
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City | NEW IBERIA
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State | LA
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Zip | 70563-1281
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Country | US
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Telephone | 337-967-3016
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. YOLANDA NARCISSE BREAUX
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Credential | FNP
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Telephone | 337-484-3216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 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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