Individual
RACHEL WATSON WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PNP
Contact information
Practice address
600 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-6371
Mailing address
600 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-6371
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
A005238
AR
363LP0200X
Pediatric Nurse Practitioner
Primary
RN108921-AP06666
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007095465
LOUISIANA DRIVERS LICENSE
LA
01
—
060129
PRESCRIPTIVE AUTHORITY - LOUISIANA STATE BOARD OF NURSING
LA
05
—
2177079
—
LA
Enumeration date
01/06/2012
Last updated
08/12/2025
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