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Individual

MRS. KACIE WALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
6614 MAIN ST, WINNSBORO, LA 71295-2762
(318) 435-2143
Mailing address
6614 MAIN ST, WINNSBORO, LA 71295-2762
(318) 435-2143

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN126629
LA

Other

Enumeration date
05/19/2014
Last updated
05/19/2014
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