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NPI Code Detail

MEDICARE: MISS ALICA CARYNN BRISTER RN, BSN

MEDICARE: MISS ALICA CARYNN BRISTER RN, BSN
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
1163WC1500XCommunity Health Registered Nurse204523LA

General Provider Information

NPI Number : 1851121297
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ALICA CARYNN BRISTER RN, BSN
Provider Business Mailing Address
First Line : 5604 COLISEUM BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3676
Country : US
Telephone Number : 318-487-5282
Fax Number : 318-487-5330
Provider Business Practice Location Address
First Line : 5604 COLISEUM BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3676
Country : US
Telephone Number : 318-487-5282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2024
Last Update Date : 08/01/2024

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