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Individual

MRS. JORDAN CAGE WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2449 HOSPITAL DR STE 300, BOSSIER CITY, LA 71111-1910
(318) 212-7960
(318) 212-7965
Mailing address
2449 HOSPITAL DR STE 300, BOSSIER CITY, LA 71111-1910
(318) 212-7960
(318) 212-7965

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
328850
LA

Other

Enumeration date
09/28/2021
Last updated
02/10/2025
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