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Individual

PATTI C. WASCOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
433 PLAZA ST STE 2A, BOGALUSA, LA 70427-3729
(985) 730-7020
(985) 730-7022
Mailing address
58625 MOCSAW RD., BOGALUSA, LA 70427
(985) 730-7020
(985) 730-7022

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN055001
LA
363LF0000X
Family Nurse Practitioner
Primary
AP02803
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1694207
LA
Enumeration date
07/15/2006
Last updated
05/19/2021
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