Individual
MS. WINTRESS BLYTH MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, CBC
Contact information
Practice address
7020 HIGHWAY 190 STE C, COVINGTON, LA 70433-4962
(985) 871-7337
(985) 871-7600
Mailing address
7020 HIGHWAY 190 STE C, COVINGTON, LA 70433-4962
(985) 871-7337
(985) 871-7600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
20180342
LA
174N00000X
Lactation Consultant (Non-RN)
Primary
22098
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20180342
LOUISIANA STATE BOARD OF NURSING
LA
01
—
22098
PREPARED CHILDBIRTH EDUCATORS
LA
Enumeration date
07/06/2022
Last updated
07/06/2022
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