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NPI Code Detail

MEDICARE: KITTY E WALPOLE CPT.002624

MEDICARE: KITTY E WALPOLE CPT.002624
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
1183700000XPharmacy TechnicianCPT002624LA

General Provider Information

NPI Number : 1396329389
Entity Type Code : Individual
Provider Name (Legal Business Name) : KITTY E WALPOLE CPT.002624
Provider Business Mailing Address
First Line : 2400 CYPRESS ST
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-4555
Country : US
Telephone Number : 318-267-3001
Fax Number :
Provider Business Practice Location Address
First Line : 2400 CYPRESS ST
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-4555
Country : US
Telephone Number : 318-267-3001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2021
Last Update Date : 05/06/2021

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