Elizabeth Family Clinic | |
4855 Highway 10 West Suite C Elizabeth LA 70638 | |
(318) 634-5600 | |
(318) 634-5602 |
Full Name | Elizabeth Family Clinic |
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Speciality | Clinic/Center |
Location | 4855 Highway 10 West, Elizabeth, Louisiana |
Authorized Official Name and Position | Alec Donovan Jeansonne (CEO) |
Authorized Official Contact | 3188802144 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elizabeth Family Clinic 912 Bryan St Cottonport LA 71327-4288 Ph: (888) 995-0591 | Elizabeth Family Clinic 4855 Highway 10 West Suite C Elizabeth LA 70638 Ph: (318) 634-5600 |
NPI Number | 1841908761 |
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Provider Enumeration Date | 11/09/2022 |
Last Update Date | 11/11/2022 |
Medicare PECOS PAC ID | 1254701121 |
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Medicare Enrollment ID | O20230111000104 |
Identifier | Type | State | Issuer |
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1841908761 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Angela D Huval |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1639489487 PECOS PAC ID: 4486808763 Enrollment ID: I20130214000368 |
Provider Name | Anastasia M Guillory |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629544069 PECOS PAC ID: 8224379235 Enrollment ID: I20190401000433 |
Provider Name | Heather Johnson Palazzo |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1114322146 PECOS PAC ID: 8820481716 Enrollment ID: I20220217002155 |
Provider Name | Misty Danielle Martin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427763085 PECOS PAC ID: 2769855923 Enrollment ID: I20230308003294 |
Provider Name | Ashley Sarah Farris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881471571 PECOS PAC ID: 9638525744 Enrollment ID: I20231026000288 |
Provider Name | Laurel Lachelle Sanders |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1942865332 PECOS PAC ID: 9830541358 Enrollment ID: I20240122000144 |