MEDICARE: WILLOW TOTAL HEALTH LLC

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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1255131413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLOW TOTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	108 WINDY FEATHER DR
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-7947
Country	:	US
Telephone Number	:	337-336-2994
Fax Number	:

Provider Business Practice Location Address
First Line	:	4016 HIGHWAY 90 E STE 112
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-3548
Country	:	US
Telephone Number	:	337-761-0808
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	SHELBI MEYER
Credential	:	FNP
Telephone Number	:	337-336-2994

Provider Enumeration Date	:	03/17/2025
Last Update Date	:	06/12/2025

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Directions to “WILLOW TOTAL HEALTH LLC ” Practice Location

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