NPI 1124792122

Cinnamin Marchall White

Practitioner Contractor Zachary, LA

Practice location

Address: 18018 Smallen Dr, Zachary, LA 70791-8236
Phone: (225) 610-7735

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 011505013 (LA)

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Registry record

NPI: 1124792122
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Aug 2021
Record last updated: 3 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.