Lori S Grace, NP | |
6550 Main St Ste 3500, Zachary, LA 70791-4092 | |
(225) 658-6780 | |
(225) 658-6781 |
Full Name | Lori S Grace |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 6550 Main St Ste 3500, Zachary, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023679040 | NPI | - | NPPES |
2506081 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | AP206404 (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 | Calcasieu Urgent Care Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467715490 PECOS PAC ID: 5496908071 Enrollment ID: O20130109000768 |
Mailing Address | Practice Location Address |
---|---|
Lori S Grace, NP 2335 Church St Ste E, Zachary, LA 70791-2700 Ph: (225) 570-2489 | Lori S Grace, NP 6550 Main St Ste 3500, Zachary, LA 70791-4092 Ph: (225) 658-6780 |
Michael Evan Williams, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6550 Main St Ste 1000, Zachary, LA 70791 Phone: 225-654-1559 Fax: 225-654-6212 | |
Courtney B Johnson, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 19900 Old Scenic Hwy Ste H, Zachary, LA 70791 Phone: 225-570-2618 | |
Jeremy Dedeaux, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2335 Church St, Suite E, Zachary, LA 70791 Phone: 225-654-3607 Fax: 225-658-2262 | |
Chantel N Wiley, FNP, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1215 Independence Blvd Ste B, Zachary, LA 70791 Phone: 225-205-3664 Fax: 225-399-4590 | |
Mrs. Celeste M Howard-bourque, PMHNP-BC, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4544 W Central Ave, Zachary, LA 70791 Phone: 337-739-9824 | |
Loryn Culver Matthews, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 18989 Old Scenic Hwy, Zachary, LA 70791 Phone: 225-654-8850 |