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Individual

HOLLY WELLMAN TRAVIS CHANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7777 BLUEBONNET BLVD STE 100, BATON ROUGE, LA 70810-1632
(225) 766-9091
(225) 766-9317
Mailing address
7777 BLUEBONNET BLVD. STE 100, BATON ROUGE, LA 70810
(225) 766-9091
(225) 766-9317

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP06560
LA
363LF0000X
Family Nurse Practitioner
Primary
AP06560
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2157060
LA
Enumeration date
07/15/2011
Last updated
03/17/2016
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