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NPI Code Detail

MEDICARE: CALLIE ENTWISLE

MEDICARE: CALLIE ENTWISLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse908572MS
2367500000XCertified Registered Nurse Anesthetist233921LA

General Provider Information

NPI Number : 1033898036
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALLIE ENTWISLE
Provider Business Mailing Address
First Line : 1451 GRANBY DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70820-5305
Country : US
Telephone Number : 662-812-6571
Fax Number :
Provider Business Practice Location Address
First Line : 5220 ESSEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3542
Country : US
Telephone Number : 225-354-9981
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 12/29/2023

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Directions to “ CALLIE ENTWISLE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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