Healthcare Provider Details

I. General information

NPI: 1083814073
Provider Name (Legal Business Name): TWYLA HURST FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 JIMMIE DAVIS HWY STE 200
BOSSIER CITY LA
71112-4515
US

IV. Provider business mailing address

3330 BARKSDALE BLVD. BOSSIER FAMILY MEDICAL CLINIC
BOSSIER CITY LA
71112
US

V. Phone/Fax

Practice location:
  • Phone: 318-681-1660
  • Fax: 318-681-1671
Mailing address:
  • Phone: 318-841-5541
  • Fax: 318-841-5545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP05270
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: