Individual
MR. MATTHEW BRENT WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-C
Contact information
Practice address
101 PROFESSIONAL DR, WEST MONROE, LA 71291-8309
(318) 387-5244
(318) 398-9986
Mailing address
325 EVERGREEN ST, WEST MONROE, LA 71292-6458
(318) 512-4443
(318) 398-9986
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04788
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1787132
—
LA
Enumeration date
11/15/2005
Last updated
03/17/2008
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