Provider Demographics
NPI:1801682281
Name:SOUTHWEST WELLNESS LLC
Entity type:Organization
Organization Name:SOUTHWEST WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHU JUN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MSN, AGPCNP-C
Authorized Official - Phone:504-957-9352
Mailing Address - Street 1:620 OAK HARBOR BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8862
Mailing Address - Country:US
Mailing Address - Phone:985-774-8091
Mailing Address - Fax:
Practice Address - Street 1:620 OAK HARBOR BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-8862
Practice Address - Country:US
Practice Address - Phone:985-774-8091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty