Individual
SAMANTHA WOMELDORFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-6565
Mailing address
6136 PELICAN CROSSING DR, GONZALES, LA 70737-8616
(440) 223-5227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200776
LA
Other
Enumeration date
10/21/2014
Last updated
10/21/2014
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