Individual
MS. SIEDA MARIE MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
38058 HIGHWAY 621 STE B, GONZALES, LA 70737-6072
(225) 402-2091
Mailing address
38058 HIGHWAY 621 STE B, GONZALES, LA 70737-6072
(225) 402-2091
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
290500
LA
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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