Healthcare Provider Details

I. General information

NPI: 1720842248
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 B SOUTH GIROUARD DR
BROUSSARD LA
70518-5220
US

IV. Provider business mailing address

3100 JANE ST
NEW IBERIA LA
70563-1003
US

V. Phone/Fax

Practice location:
  • Phone: 337-369-0008
  • Fax:
Mailing address:
  • Phone: 337-288-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMBER LITTLEFIELD
Title or Position: OWNER/NP
Credential: DNP, PMHNP-BC
Phone: 337-288-2240