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General NPI Number Information
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NPI Number | 1962267922
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Entity Type | Organization
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Legal Business Name | CHOUDRANT PRIMARY CARE LLC
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 3845 ELM ST STE 3
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City | CHOUDRANT
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State | LA
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Zip | 71227-3017
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Country | US
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Telephone | 318-695-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 216 LOBLOLLY LN
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City | CHOUDRANT
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State | LA
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Zip | 71227-4804
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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 | OWNER
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Name | JENNIFER S. JUNEAU
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Credential | APRN, CNP
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Telephone | 318-695-9200
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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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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