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NPI Code Detail

MEDICARE: WYNNER WARD

MEDICARE: WYNNER WARD
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
1104100000XSocial WorkerLA

General Provider Information

NPI Number : 1588530778
Entity Type Code : Individual
Provider Name (Legal Business Name) : WYNNER WARD
Provider Business Mailing Address
First Line : 829 E GEORGIA AVE STE 3
Second Line :
City : RUSTON
State : LA
Zip : 71270-3901
Country : US
Telephone Number : 318-242-0730
Fax Number :
Provider Business Practice Location Address
First Line : 829 E GEORGIA AVE STE 3
Second Line :
City : RUSTON
State : LA
Zip : 71270-3901
Country : US
Telephone Number : 318-242-0730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2025
Last Update Date : 05/13/2026

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Directions to “ WYNNER WARD ” Practice Location

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