Kori Fogg Juban
Kori Fogg Juban is a Nurse Practitioner in Walker, Louisiana. Qualified in 2016, 10 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Louisiana.
- Years since qualifying
- 10
- Licensed in
- LA
- In the registry since
- 2017
Practice location Address checks out
5000 Odonavan Blvd Ste 404Walker, LA 70785-6355
Phone: (225) 369-8100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence AP09218 (LA) |
|---|
Record details
| NPI number | 1346761301 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | June 29, 2017 |
| Last updated in NPPES | March 30, 2021 |
| Certification date | March 30, 2021 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2016 (10 years in practice) |
| Group practice | Our Lady Of The Lake Physician Group Llc — 635 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
Other providers in Walker
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Strong Tower Medicine LLC
34578 Quarter Horse Ln, Walker, LA 70785 · (225) 281-9576