NPI 1053734780 · live from the CMS NPI Registry
Affinity Health Group, LLC
Family Medicine in Monroe, LA. National Provider Identifier 1053734780, active.
NPI record
| NPI | 1053734780 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 1140 University Ave, Monroe, LA 71209 |
| Practice phone | 318-342-1651 |
| Mailing address | 130 Desiard St, Suite 355, Monroe, LA 71201 |
| Enumerated | January 31, 2014 |
| Last updated | January 31, 2014 |
| Authorized official | Mike Breard, Vice President |
| Other names | Affinity Health Group Ulm Clinic |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | — |
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.