| |
101 Crosley St West Monroe LA 71291-2913 | |
(318) 325-1092 | |
(318) 325-1222 |
Full Name | |
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Speciality | Clinic/Center |
Location | 101 Crosley St, West Monroe, Louisiana |
Authorized Official Name and Position | Nancy Head (CFO) |
Authorized Official Contact | 3185823587 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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101 Crosley St West Monroe LA 71291-2913 Ph: (318) 325-1092 | 101 Crosley St West Monroe LA 71291-2913 Ph: (318) 325-1092 |
NPI Number | 1003207085 |
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Provider Enumeration Date | 02/11/2015 |
Last Update Date | 04/01/2024 |
Medicare PECOS PAC ID | 2264744028 |
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Medicare Enrollment ID | O20150708000073 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003207085 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Laurie L Hamilton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154549079 PECOS PAC ID: 4981699444 Enrollment ID: I20040415000870 |
Provider Name | David A Culp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477565331 PECOS PAC ID: 6608882394 Enrollment ID: I20060306000150 |
Provider Name | Tammy Venee Jones |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619980380 PECOS PAC ID: 8224221551 Enrollment ID: I20101019001429 |
Provider Name | Amanda M Norris |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1639474810 PECOS PAC ID: 2264605203 Enrollment ID: I20111107000825 |
Provider Name | Mia Mccall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932719200 PECOS PAC ID: 3173934684 Enrollment ID: I20201203002804 |
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