MEDICARE: MS. OLIVIA P LANCLOS MSN, APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	217865	LA

General Provider Information

NPI Number	:	1467385914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. OLIVIA P LANCLOS MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	9570 LINWOOD AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7522
Country	:	US
Telephone Number	:	337-351-7409
Fax Number	:

Provider Business Practice Location Address
First Line	:	9570 LINWOOD AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7522
Country	:	US
Telephone Number	:	337-351-7409
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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