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General NPI Number Information
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NPI Number | 1285977710
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Entity Type | Individual
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Provider Name | CHARLOTTE ASTRID VIVIENNE VONN MD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 2106 LOOP RD
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City | WINNSBORO
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State | LA
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Zip | 71295-3344
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Country | US
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Telephone | 318-435-9411
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W 134TH PL
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City | CUT OFF
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State | LA
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Zip | 70345-4143
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Country | US
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Telephone | 985-325-9333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.207500
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD.207500
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License Number State | LA
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