Individual
DIANNA WALLER WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1051 GAUSE BLVD, SUITE 380, SLIDELL, LA 70458-2951
(985) 641-8191
(985) 641-9812
Mailing address
1375 CORPORATE SQUARE DR, SLIDELL, LA 70458-3147
(985) 649-1152
(985) 643-9808
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
AP06883
LA
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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