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Individual

CHERIE MCKEITHEN BAGWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
7777 HENNESSY BLVD, STE 701, BATON ROUGE, LA 70808-4300
(225) 765-5864
(225) 765-2013
Mailing address
7777 HENNESSY BLVD, STE 701, BATON ROUGE, LA 70808-4300
(225) 765-5864
(225) 765-2013

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN096425AP06087
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03129730
MS
05
2101072
LA
Enumeration date
12/10/2009
Last updated
01/06/2021
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