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1396363438
BLAKE MCCULLOUGH WILLIAMS
DERIDDER, LA
NPI
1396363438
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: LA 214331)
Enumeration Date
2020-07-06
Last Update Date
2020-07-06
Business Address
BLAKE MCCULLOUGH WILLIAMS FNP
1017 N PINE ST
DERIDDER, LA 70634-2817
Phone number: 337-202-4101
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Mailing Address
BLAKE MCCULLOUGH WILLIAMS FNP
335 CARTER RD
DRY CREEK, LA 70637-5029
Phone number: 318-308-4063
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