Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 221504 | LA |
NPI | 1033727169 |
---|---|
Provider Name | Wendy Webb |
First Address | Harvey, LA 70058-7300 |
Second Address | Harvey, LA 70058-7306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2020 |
Last Update Date | 07/12/2021 |