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Organization

VITAL BRANCH WELLNESS SOLUTIONS LLC

Active
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Organization

VITAL BRANCH WELLNESS SOLUTIONS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEXANDRA STEWART APRN-CNP (MANAGER)
(318) 773-8241
Entity
Organization

Contact information

Practice address
8156 MYRTLEWOOD RD, GREENWOOD, LA 71033-3024
(318) 773-8241
Mailing address
2829 YOUREE DR STE 1, SHREVEPORT, LA 71104-3640

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM1300X
Multi-Specialty Clinic/Center
Primary
363L00000X
Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
363LS0200X
School Nurse Practitioner

Other

Enumeration date
09/24/2024
Last updated
09/24/2024
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