Type 1 individualNPI 1003491960
BRANDIE MARIE WILDER RD
133VN1004X · PRAIRIEVILLE, LA
Why this profile is appearing now
Observed change signals
No current public change signal is attached to this profile.
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 133VN1004X | 133VN1004X | Primary |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s