| Nightingail Healthcare Resources | |
|
1910 Jackson St Monroe LA 71202-2532 | |
| (318) 325-7998 | |
| (318) 398-4263 |
| Full Name | Nightingail Healthcare Resources |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1910 Jackson St, Monroe, Louisiana |
| Authorized Official Name and Position | Wanda G Smith (PROVIDER) |
| Authorized Official Contact | 3183257998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nightingail Healthcare Resources 1910 Jackson St Monroe LA 71202-2532 Ph: (318) 325-7998 | Nightingail Healthcare Resources 1910 Jackson St Monroe LA 71202-2532 Ph: (318) 325-7998 |
| NPI Number | 1679042287 |
|---|---|
| Provider Enumeration Date | 11/13/2018 |
| Last Update Date | 08/04/2022 |
| Medicare PECOS PAC ID | 4587900741 |
|---|---|
| Medicare Enrollment ID | O20190108003567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679042287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Wanda G Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942755863 PECOS PAC ID: 6406116151 Enrollment ID: I20180129001166 |
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