ADVANCED PRACTICE ASSOCIATES, LLC - NPI NUMBER 1588949226

Summary

Provider Name: ADVANCED PRACTICE ASSOCIATES, LLC

NPI Number: 1588949226

Clasification: Nurse Practitioner (363LF0000X)

Specialization: Family

Address:
6302 DIAMOND HEAD DR
MONROE, LA
ZIP 71203

Phone Number: (318) 235-7033



Detailed Information

ADVANCED PRACTICE ASSOCIATES, LLC is a family nurse practitioner in Monroe, LA. The assigned NPI number for this provider is 1588949226 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

6302 DIAMOND HEAD DR
MONROE, LA
ZIP 71203-216
Phone: (318) 235-7033

The provider's authorized official is Tiana Williams .
The authorized official title is Nurse Practitioner and has the following contact phone number (318) 235-7033.

The enumeration date for this NPI number is 10/13/2011 and was last updated on 12/9/2011.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363LF0000X Nurse Practitioner Family RN094823-AP05552 LA Yes

NPI Record

No. Field Name Field Value
1 NPI 1588949226
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name ADVANCED PRACTICE ASSOCIATES, LLC
5 Provider First Line Business Practice Location Address 6302 DIAMOND HEAD DR
6 Provider Business Practice Location Address City Name MONROE
7 Provider Business Practice Location Address State Name LA
8 Provider Business Practice Location Address Postal Code 712033216
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 3182357033
11 Provider Enumeration Date 10/13/2011
12 Last Update Date 12/9/2011
13 Authorized Official Last Name WILLIAMS
14 Authorized Official First Name TIANA
15 Authorized Official Title or Position NURSE PRACTITIONER
16 Authorized Official Telephone Number 3182357033
17 Healthcare Provider Taxonomy Code 1 363LF0000X
18 Provider License Number 1 RN094823-AP05552
19 Provider License Number State Code 1 LA
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 7/15/2014
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