Individual
CHARLSA MCGREGOR WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
44617 S AIRPORT RD STE C&D, HAMMOND, LA 70403-0311
(985) 429-7611
Mailing address
44617 S AIRPORT RD STE C&D, HAMMOND, LA 70403-0311
(985) 429-7611
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN150885
LA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN150885
LA
Other
Enumeration date
10/29/2018
Last updated
11/16/2018
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