MEDICARE: EMILY LEANNE TULL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	AP10007	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386137586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY LEANNE TULL NP

Provider Business Mailing Address
First Line	:	1455 E BERT KOUNS INDUSTRIAL LOOP
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-6000
Country	:	US
Telephone Number	:	318-798-4500
Fax Number	:	318-798-4601

Provider Business Practice Location Address
First Line	:	1455 E BERT KOUNS INDUSTRIAL LOOP STE 300
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-6000
Country	:	US
Telephone Number	:	318-798-4488
Fax Number	:	318-798-4575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2018
Last Update Date	:	02/02/2026

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Directions to “ EMILY LEANNE TULL NP” Practice Location

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