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Individual

WILLIAM R NETTERVILLE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-7109
Mailing address
392 HALF MOON CT, BOSSIER CITY, LA 71111-5569
(318) 347-5591
(318) 222-0724

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
113623
LA

Other

Enumeration date
01/19/2012
Last updated
01/19/2012
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