Provider Demographics
NPI:1487391462
Name:MISS LOU FAMILY HEALTH, INC
Entity type:Organization
Organization Name:MISS LOU FAMILY HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:318-414-2315
Mailing Address - Street 1:1648 CARTER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-3111
Mailing Address - Country:US
Mailing Address - Phone:318-414-2315
Mailing Address - Fax:318-414-2286
Practice Address - Street 1:1648 CARTER ST STE 2
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3111
Practice Address - Country:US
Practice Address - Phone:318-414-2315
Practice Address - Fax:318-414-2286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1245496579Medicaid