| NPI | 1952154056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER STOUT Credentialing Manager 337-315-7927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-04-09 |