# WOUND CARE NP OF SOUTHEAST LA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679001556
- **Authorized official:** JENNIFER MELTON DUCOTE (FNP-C)
- **Authorized official phone:** (504) 897-7732

## Contact information

- **Practice address:** 1401 FOUCHER ST, NEW ORLEANS, LA 70115-3515
- **Practice address phone:** (504) 897-7732
- **Mailing address:** 70380 HIGHWAY 21, SUITE 2 \#242, COVINGTON, LA 70433-3420
- **Mailing address phone:** (504) 236-3751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | AP09197 | LA | Yes |

## Other

- **Enumeration date:** 05/23/2017
- **Last updated:** 03/14/2018