Provider Demographics
NPI:1154152130
Name:AMERICAN SOLDIER EVALUATION SERVICES
Entity type:Organization
Organization Name:AMERICAN SOLDIER EVALUATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NKOUGA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:225-577-9009
Mailing Address - Street 1:37283 SWAMP RD STE 1001
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3298
Mailing Address - Country:US
Mailing Address - Phone:225-577-9009
Mailing Address - Fax:
Practice Address - Street 1:37283 SWAMP RD STE 1001
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3298
Practice Address - Country:US
Practice Address - Phone:225-577-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty