Individual
KASSIDY B WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1970 N HIGHWAY 190, COVINGTON, LA 70433-5364
(985) 400-5988
(985) 867-3644
Mailing address
PO BOX 3370, COVINGTON, LA 70434-3370
(985) 867-8585
(985) 867-3644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09476
LA
Other
Enumeration date
08/01/2017
Last updated
09/29/2025
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