Provider Demographics
NPI:1093077299
Name:OFFICE OF PUBLIC HEALTH/GPHU
Entity Type:Organization
Organization Name:OFFICE OF PUBLIC HEALTH/GPHU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE 3
Authorized Official - Prefix:
Authorized Official - First Name:JANELL
Authorized Official - Middle Name:P
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-640-2543
Mailing Address - Street 1:679 GRAYS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DRY PRONG
Mailing Address - State:LA
Mailing Address - Zip Code:71423-3528
Mailing Address - Country:US
Mailing Address - Phone:318-640-2543
Mailing Address - Fax:
Practice Address - Street 1:340A WEBB SMITH DR
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:LA
Practice Address - Zip Code:71417-1910
Practice Address - Country:US
Practice Address - Phone:318-627-3133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN082725251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare