| NPI | 1225883184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER STOUT Credentialing Manager 337-315-7927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse Wound Care |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2024-04-23 |