Individual
ANNIE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1281 W TUNNEL BLVD, HOUMA, LA 70360-2794
(985) 876-2321
(985) 917-0808
Mailing address
1281 W TUNNEL BLVD, HOUMA, LA 70360-2794
(985) 876-2321
(985) 917-0808
Taxonomy
Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
AP03922
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154636
—
LA
Enumeration date
05/14/2008
Last updated
08/04/2015
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