KERRI LUCKEN TYNES P.A. NPI 1104004720

NPI Information

  • NPI: 1104004720
  • Provider Name: KERRI LUCKEN TYNES, P.A.
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 2300 HOSPITAL DR
    SUITE 450
    BOSSIER CITY, LA
    ZIP 71111
  • Phone: (318) 752-2328

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NPI Details

Kerri Lucken Tynes, P.A. is a medical physician assistant in Bossier City, LA. Kerri Lucken Tynes, P.A. NPI is 1104004720. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2300 HOSPITAL DR
SUITE 450
BOSSIER CITY, LA
ZIP 71111-394
Phone: (318) 752-2328
Fax: (318) 746-0160

The enumeration date for this NPI number is 2/6/2008 and was last updated on 2/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1363AM0700XPhysician AssistantMedicalA10314LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1S63026MEDICARE UPINLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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