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COMMUNITY HEALTHCARE CLINIC LLC NPI 1396138145


NPI Information

NPI: 1396138145
Provider Name: COMMUNITY HEALTHCARE CLINIC, LLC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Organization

Specialization: Adult Health

CLIA Number: 19D2008615

Address:
1421 HENDERSON HIGHWAY
HENDERSON, LA
ZIP 70517
Phone: (337) 434-6146
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COMMUNITY HEALTHCARE CLINIC, LLC is an adult health nurse practitioner in Henderson, LA. COMMUNITY HEALTHCARE CLINIC, LLC NPI is 1396138145. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1421 HENDERSON HIGHWAY
HENDERSON, LA
ZIP 70517
Phone: (337) 434-6146
Fax: (337) 464-6149

The provider's authorized official is Aimee D, Guidry .
The authorized official title is Owner and has the following contact phone number (337) 288-1508.

The CLIA number assigned to this NPI record is 19D2008615 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/17/2015 and was last updated on 3/17/2015.


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
1363LA2200XNurse PractitionerAdult HealthAP04925LOUISIANAYes

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
11820466MEDICAIDLOUISIANA
23B399MEDICARE 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: 5/5/2024
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