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MINOR MEDICAL CLINIC LLC NPI 1720008675


NPI Information

NPI: 1720008675
Provider Name: MINOR MEDICAL CLINIC LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
109 EXECUTIVE DR.
SUITE C
LAKE CHARLES, LA
ZIP 70611
Phone: (337) 217-0922
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MINOR MEDICAL CLINIC LLC is a health service clinic center in Lake Charles, LA. MINOR MEDICAL CLINIC LLC NPI is 1720008675. The provider is registered as an organization entity type.

The provider's business location address is:

109 EXECUTIVE DR.
SUITE C
LAKE CHARLES, LA
ZIP 70611-328
Phone: (337) 217-0922
Fax: (337) 217-0925

The provider's authorized official is Karen Marie Whitehead .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (337) 217-0922.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 11/5/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QH0100XClinic/CenterHealth ServiceLOUISIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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