MEDICARE: APN SERVICES, LLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1871948380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APN SERVICES, LLC

Provider Business Mailing Address
First Line	:	1509 DULLES DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-3718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 WARNOCK SPRINGS RD
Second Line	:
City	:	MAGNOLIA
State	:	AR
Zip	:	71753-9000
Country	:	US
Telephone Number	:	337-991-9276
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	ROSS PONTHIE
Credential	:
Telephone Number	:	337-991-9276

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	05/03/2016

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