Individual
CALLIE ENTWISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5220 ESSEN LN, BATON ROUGE, LA 70809-3542
(225) 354-9981
Mailing address
1451 GRANBY DR, BATON ROUGE, LA 70820-5305
(662) 812-6571
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
908572
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
233921
LA
Other
Enumeration date
07/17/2023
Last updated
12/29/2023
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