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Individual

AMBER SISTRUNK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
24278 WATER HICKORY RD, PONCHATOULA, LA 70454-4255
(985) 960-4423
Mailing address
24278 WATER HICKORY RD, PONCHATOULA, LA 70454-4255

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20101126
LA

Other

Enumeration date
11/14/2025
Last updated
11/14/2025
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