Individual
WALTER MATHENY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN FNP-C
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
215856
LA
363LF0000X
Family Nurse Practitioner
Primary
215856
LA
Other
Enumeration date
10/27/2020
Last updated
02/28/2023
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