Louisiana Stat Care Llc | |
11055 Shoe Creek Dr Baton Rouge LA 70818-4022 | |
(225) 261-4493 | |
Not Available |
Full Name | Louisiana Stat Care Llc |
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Speciality | General Practice |
Location | 11055 Shoe Creek Dr, Baton Rouge, Louisiana |
Authorized Official Name and Position | Amanda Woodard (OWNER) |
Authorized Official Contact | 2252614493 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Louisiana Stat Care Llc 11055 Shoe Creek Dr Baton Rouge LA 70818-4022 Ph: (225) 261-4493 | Louisiana Stat Care Llc 11055 Shoe Creek Dr Baton Rouge LA 70818-4022 Ph: (225) 261-4493 |
NPI Number | 1891517512 |
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Provider Enumeration Date | 10/25/2024 |
Last Update Date | 01/14/2025 |
Medicare PECOS PAC ID | 3870028491 |
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Medicare Enrollment ID | O20241119004702 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891517512 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Provider Name | Norman G Neal |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821089822 PECOS PAC ID: 3678552007 Enrollment ID: I20040719000397 |
Provider Name | Rosaline Osu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235653890 PECOS PAC ID: 3072885987 Enrollment ID: I20170826000173 |
Provider Name | Crissy D Devall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598250870 PECOS PAC ID: 4284983164 Enrollment ID: I20180827001518 |
Provider Name | Christopher B Staggers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184283236 PECOS PAC ID: 8820327778 Enrollment ID: I20190903001064 |
Provider Name | Rebekah J Schmieder |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285293464 PECOS PAC ID: 0749519494 Enrollment ID: I20190906000069 |
Provider Name | Rebecca Chair Muzika |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396318978 PECOS PAC ID: 6204226111 Enrollment ID: I20211208003208 |
Provider Name | Deanna N Ibrahim |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497473268 PECOS PAC ID: 6204291412 Enrollment ID: I20230421002631 |
Provider Name | Angela D Kennerly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275249088 PECOS PAC ID: 8527424001 Enrollment ID: I20230525003279 |
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