Samuel Lamont Jerideau R.N.

NPI 1790719748 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1790719748
Gender Male
Enumeration Date 07/10/2006
Last Updated 09/26/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
1459 ACTON AVE
DUNCANVILLE TX, 75137-3338, US
Phone (972) 780-0118
Fax (972) 780-0491
Business Location
1459 ACTON AVE
DUNCANVILLE TX, 75137-3338, US
Phone (972) 780-0118
Fax (972) 780-0491
Toxanomy
Taxonomy Code 363LF0000X
License State Texas
License Number 651668
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According to our database, Samuel Lamont Jerideau R.N. NPI is 1790719748, taxonomy code is 363LF0000X and license number is 651668, license state is located at Texas. Samuel Lamont Jerideau R.N. physically located at 1459 Acton Ave, Duncanville TX, 75137-3338. NPI Number Samuel Lamont Jerideau R.N. has the Individual type.

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1790719748 NPI number is provided on an as is basis without warranty of any kind. 1790719748 is maintained by the National Plan & Provider Enumeration System. The contents of Samuel Lamont Jerideau R.N. are for informational purposes only.