| Justin Bohannan, AG-ACNP | |
|
2770 3rd Ave Ste 350, Lake Charles, LA 70601-0404 | |
| (337) 494-2750 | |
| (337) 494-2760 |
| Full Name | Justin Bohannan |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Acute Care |
| Location | 2770 3rd Ave Ste 350, Lake Charles, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124695408 | NPI | - | NPPES |
| 219004 | Other | LA | STATE LICENSE |
| 2560891 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2100X | Nurse Practitioner - Acute Care | 219004 (Louisiana) | Primary |
| Entity Name | Lcms Pulmonary Associates Of Southwest Louisiana |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508175704 PECOS PAC ID: 0446439939 Enrollment ID: O20110131000436 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Bohannan, AG-ACNP Po Box 122309 Dept 2309, Dallas, TX 75312-0001 Ph: (337) 494-2772 | Justin Bohannan, AG-ACNP 2770 3rd Ave Ste 350, Lake Charles, LA 70601-0404 Ph: (337) 494-2750 |
Ms. Victoria Lee Skold, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1510 W Mcneese, Lake Charles, LA 70605 Phone: 337-478-3177 | |
Rebecca Ellen Godare Stein, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 600 Dr Michael Debakey Dr, Lake Charles, LA 70601 Phone: 337-436-3813 Fax: 337-439-0214 | |
Darci Portie, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 803 W Bayou Pines Dr Ste B, Lake Charles, LA 70601 Phone: 337-508-2333 Fax: 337-549-6316 | |
Mrs. Ilea Nauts, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2770 3rd Ave Ste 120, Lake Charles, LA 70601 Phone: 337-494-4868 Fax: 337-494-4870 | |
Mrs. Yvonne Eileen Alexander, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1701 Oak Park Blvd, Lake Charles, LA 70601 Phone: 337-494-3036 | |
Megan Leblanc Thibodeaux, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2005 Southwood Dr, Lake Charles, LA 70605 Phone: 337-562-2293 Fax: 337-562-0765 | |
Mrs. Cynthia Trahan Cox, APRN FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 730 Tallow Rd, Lake Charles, LA 70607 Phone: 337-884-4498 |