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CAMILLE THOMPSON WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
104 MORRIS CIR, HOMER, LA 71040-2100
(318) 927-1110
(318) 927-1116
Mailing address
620 E COLLEGE ST, HOMER, LA 71040-3202
(318) 927-2024
(318) 927-3547

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN078196 AP04243
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1721123
LA
Enumeration date
07/07/2006
Last updated
10/07/2008
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