Healthcare Provider Details

I. General information

NPI: 1619881562
Provider Name (Legal Business Name): WENDI WORSHAM PARAMEDIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 HOSPITAL DR
BOSSIER CITY LA
71111-2385
US

IV. Provider business mailing address

108 WPA RD
COUSHATTA LA
71019-7125
US

V. Phone/Fax

Practice location:
  • Phone: 318-212-7000
  • Fax:
Mailing address:
  • Phone: 318-212-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP0909726
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: