Pine Prairie Family Healthcare, Llc | |
1015 Sanders Street Pine Prairie LA 70576-3611 | |
(337) 599-2850 | |
(337) 599-2852 |
Full Name | Pine Prairie Family Healthcare, Llc |
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Speciality | Clinic/Center |
Location | 1015 Sanders Street, Pine Prairie, Louisiana |
Authorized Official Name and Position | Nicole Doucet (FNP) |
Authorized Official Contact | 3377796000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pine Prairie Family Healthcare, Llc 1015 Sanders Street Po Box 736 Pine Prairie LA 70576-3611 Ph: (337) 599-2850 | Pine Prairie Family Healthcare, Llc 1015 Sanders Street Pine Prairie LA 70576-3611 Ph: (337) 599-2850 |
NPI Number | 1588080386 |
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Provider Enumeration Date | 03/17/2014 |
Last Update Date | 03/11/2021 |
Medicare PECOS PAC ID | 3476776394 |
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Medicare Enrollment ID | O20140522000691 |
Identifier | Type | State | Issuer |
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1588080386 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Lisa R Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053777862 PECOS PAC ID: 7416255070 Enrollment ID: I20160414001057 |
Pine Prairie Community Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1121 Walnut Street, Pine Prairie, LA 70576 Phone: 337-599-2800 Fax: 337-599-2210 |