Individual
ANGELIQUE ALEGRIA WIMBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 1000, BATON ROUGE, LA 70808-4300
(225) 767-3900
(225) 214-9109
Mailing address
7777 HENNESSY BLVD, SUITE 1000, BATON ROUGE, LA 70808-4300
(225) 767-3900
(225) 214-9109
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A30227
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1581739
—
LA
01
—
232767
WELLCARE
LA
Enumeration date
01/17/2006
Last updated
07/08/2007
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