Individual
HUONG TRAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
70411 HIGHWAY 21, COVINGTON, LA 70433-8243
(985) 400-5566
(985) 400-5560
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(985) 400-5566
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
901928
MS
363L00000X
Nurse Practitioner
AP09238
LA
363LF0000X
Family Nurse Practitioner
Primary
AP09238
LA
Other
Enumeration date
04/28/2017
Last updated
07/21/2022
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