PROVIDENCE PRIMARY CARE LLC NPI 1386238525

NPI Information

  • NPI: 1386238525
  • Provider Name: PROVIDENCE PRIMARY CARE, LLC
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • :
  • CLIA Number: 19D2233243
  • Address: 1000 CHINABERRY DR STE 1002
    BOSSIER CITY, LA
    ZIP 71111
  • Phone: (318) 562-3911

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NPI Details

PROVIDENCE PRIMARY CARE, LLC is a primary care nurse practitioner in Bossier City, LA. PROVIDENCE PRIMARY CARE, LLC NPI is 1386238525. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

1000 CHINABERRY DR STE 1002
BOSSIER CITY, LA
ZIP 71111-463
Phone: (318) 562-3911
Fax: (318) 656-3761

The provider's authorized official is Lindsey Marlowe Rodgers .
The authorized official title is Nurse Practitioner and has the following contact phone number (318) 562-3911.

The CLIA number assigned to this NPI record is 19D2233243 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2021 and was last updated on 5/2/2025.

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
1363LF0000XNurse PractitionerFamilyNo
2363LP2300XNurse PractitionerPrimary CareYes

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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