CIJI DEYUANA WALLACE

BOGALUSA, LA
NPI1487455036
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: LA  240977)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: MS  907340)
163W00000X Registered Nurse
(Licence: MS  913403)
Enumeration Date2025-03-20
Last Update Date2025-10-14
Business Address
Mrs. CIJI DEYUANA WALLACE RN-FNP
219 S BORDER DR
BOGALUSA, LA 70427-3671
Phone number: 985-633-1952
Mailing Address
Mrs. CIJI DEYUANA WALLACE RN-FNP
PO BOX 652
MC NEILL, MS 39457-0652
Phone number: 601-215-6976