Individual
MISS JOHNNETTA VIRGINIA BEVERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
737 WRIGHT AVE, GRETNA, LA 70056-4156
(504) 638-1318
(504) 362-0950
Mailing address
737 WRIGHT AVE, GRETNA, LA 70056-4156
(504) 638-1318
(504) 362-0950
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
41365
LA
Other
Enumeration date
01/19/2008
Last updated
01/19/2008
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