Individual
PAUL WESLEY CHISM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, NNP-BC
Contact information
Practice address
1 SAINT MARY PL, SHREVEPORT, LA 71101-4343
(318) 681-4500
Mailing address
1 SAINT MARY PL, SHREVEPORT, LA 71101-4343
(318) 681-4500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP05923
LA
363L00000X
Nurse Practitioner
AP118216
TX
363LN0000X
Neonatal Nurse Practitioner
774685
TX
363LN0000X
Neonatal Nurse Practitioner
AP05923
LA
363LN0005X
Critical Care Neonatal Nurse Practitioner
774685
TX
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
AP05923
LA
Other
Enumeration date
10/05/2009
Last updated
05/11/2023
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