Healthcare Provider Details

I. General information

NPI: 1063335537
Provider Name (Legal Business Name): ADELE WILLMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 BRAKEFIELD ST
SLIDELL LA
70458-3620
US

IV. Provider business mailing address

757 ENGLISH OAK DR
MADISONVILLE LA
70447-3181
US

V. Phone/Fax

Practice location:
  • Phone: 985-888-9355
  • Fax: 985-202-4597
Mailing address:
  • Phone: 985-888-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN073841
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN073841
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License NumberRN073841
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN073841
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: