NPI 1033980743

Kevin Lee Pike, DMINMDIVBCC

Practitioner Religious Nonmedical Practitioner Shreveport, LA

Practice location

Address: 510 E Stoner Ave, Shreveport, LA 71101-4243
Phone: (318) 990-5142
Mailing address: 510 E Stoner Ave, Shreveport, LA 71101-4295

Registered specialties

Religious Nonmedical Practitioner Primary

Nursing Service Related Providers Taxonomy 374K00000X

Other Religious Nonmedical Practitioner providers in Louisiana →

Registry record

NPI: 1033980743
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jan 2024
Record last updated: 11 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.