Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RAYMOND WALLACE III, LPN
ActiveMR. RAYMOND WALLACE III, LPN is a Licensed Vocational Nurse healthcare provider located in MANDEVILLE, Louisiana. NPI 1568821874 is currently active in the NPPES registry. Verify at CMS.
Licensed Vocational Nurse · MANDEVILLE, LA
Registration Details
- NPI Number
- 1568821874
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 15, 2016 (10.311050276338 yrs)
- Last Updated
- Feb 15, 2016
- License
-
20101002 (LA)
Practice Information
- Address
-
23861 SOUTH ROBIN RDMANDEVILLE, LA, 70448Browse LA providers · Browse ZIP 70448
- Phone
- 9856244100
- Primary Specialty
-
Licensed Vocational Nurse
164X00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.