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Individual

MRS. JONI DIANNE WHITEHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
567 WALKER ST, MERRYVILLE, LA 70653-3040
(337) 825-1728
(337) 825-1229
Mailing address
567 WALKER ST, MERRYVILLE, LA 70653-3040
(337) 825-1728
(337) 825-1229

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
673697
TX
363LF0000X
Family Nurse Practitioner
78494-3569
LA
363LF0000X
Family Nurse Practitioner
Primary
AP03569
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1432385
LA
05
172875001
TX
01
8N8278
BLUE CROSS/BLUE SHIELD
01
P00117217
RAILROAD MEDICARE
Enumeration date
01/25/2006
Last updated
05/26/2023
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