Dawn Malcom, FNP-C | |
106 Avenue B, Suite B, Bogalusa, LA 70427 | |
(985) 730-6950 | |
(985) 545-1036 |
Full Name | Dawn Malcom |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 106 Avenue B, Bogalusa, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215439690 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 902463 (Mississippi) | Secondary |
363LF0000X | Nurse Practitioner - Family | AP09749 (Louisiana) | Primary |
Entity Name | Our Lady Of The Lake Physician Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
Entity Name | Our Lady Of The Angels Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912334533 PECOS PAC ID: 7012144322 Enrollment ID: O20140602000869 |
Mailing Address | Practice Location Address |
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Dawn Malcom, FNP-C 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 526-0609 | Dawn Malcom, FNP-C 106 Avenue B, Suite B, Bogalusa, LA 70427 Ph: (985) 730-6950 |
Elizabeth Michelle Fitzgerald, FNP-C, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 Avenue F, Bogalusa, LA 70427 Phone: 985-730-6970 | |
Mr. Alvin Gene Williams, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2781 S Columbia St, Bogalusa, LA 70427 Phone: 985-241-5525 Fax: 985-241-5530 | |
Ms. Lisa Penton Mejia, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 433 Plaza St Ste 38, Bogalusa, LA 70427 Phone: 987-730-2284 Fax: 985-730-2305 | |
Jacqueline Baudier Walter, PNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 626 Superior Ave, Bogalusa, LA 70427 Phone: 985-730-6670 Fax: 985-730-6671 | |
Jessica Oalmann Manchester, APRN-CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 433 Plaza St, Bogalusa, LA 70427 Phone: 877-485-4474 | |
Patti C. Wascom, F.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 433 Plaza St Ste 2a, Bogalusa, LA 70427 Phone: 985-730-7020 Fax: 985-730-7022 |