Individual
MRS. KAMI WORLEY WIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2516 BROADMOOR BLVD, MONROE, LA 71201-2988
(318) 322-7726
(318) 322-2614
Mailing address
5959 S SHERWOOD FOREST BLVD STE 355, BATON ROUGE, LA 70816-6038
(318) 966-6800
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP03699
LA
363LF0000X
Family Nurse Practitioner
Primary
AP03699
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1435082
—
LA
Enumeration date
10/03/2005
Last updated
12/22/2023
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