Organization
FAMILY WELLNESS PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA MAHAFFEY APRN, FNP-C (OWNER)
(337) 221-2990
Entity
Organization
Contact information
Practice address
411 S PINE ST, DERIDDER, LA 70634-4839
(337) 462-6070
Mailing address
411 S PINE ST, DERIDDER, LA 70634-4839
(337) 221-2990
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/28/2022
Last updated
08/31/2022
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