Individual
SARAH WALLACE EISWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
19900 OLD SCENIC HWY, ZACHARY, LA 70791-7368
(225) 570-2618
(225) 570-8539
Mailing address
2335 CHURCH ST STE E, ZACHARY, LA 70791-2700
(225) 570-2489
(225) 570-2986
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
06938
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2452037
—
LA
Enumeration date
07/05/2012
Last updated
01/23/2020
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