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General NPI Number Information
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NPI Number | 1407128598
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CARE AND WELLNESS CENTER
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 2511 HIGHWAY 190 E
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City | HAMMOND
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State | LA
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Zip | 70401-8510
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Country | US
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Telephone | 985-543-6800
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Fax | 985-543-6801
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Provider Business Mailing Address
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Address Line | 2511 HIGHWAY 190 E
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City | HAMMOND
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State | LA
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Zip | 70401-8510
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Country | US
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Telephone | 985-543-6800
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Fax | 985-543-6801
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Authorized Official
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Title or Position | OWNER/NP
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Name | MRS. CHERIE K CODY
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Credential | FNP-BC
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Telephone | 985-543-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP 04596
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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