Individual
VICKI TESSITORE MATHERNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
15813 PAUL VEGA MD DR STE 200, HAMMOND, LA 70403-1431
(985) 230-7650
(985) 230-7655
Mailing address
15192 HIGHWAY 22, PONCHATOULA, LA 70454-6475
(985) 370-7953
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AP03301
LA
367A00000X
Advanced Practice Midwife
RN064193
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1543314
—
LA
01
—
AP03301
MW LICENSE
LA
Enumeration date
01/26/2007
Last updated
09/09/2025
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