Individual
MR. RODERICKUS WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8930 BAYONNE DR, SHREVEPORT, LA 71118-2033
(318) 455-2898
Mailing address
9542 LUCIEN WAY, SHREVEPORT, LA 71106-3432
(318) 455-2898
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
146918
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
221798
LA
Other
Enumeration date
02/27/2015
Last updated
08/14/2021
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