Healthcare Provider Details

I. General information

NPI: 1023113784
Provider Name (Legal Business Name): DEBRA JOYCE BAGGETT-WOODARD FNP-BC, PNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 FRANCES DR
HAYNESVILLE LA
71038-6100
US

IV. Provider business mailing address

1355 HARMON LOOP
HOMER LA
71040-5815
US

V. Phone/Fax

Practice location:
  • Phone: 318-624-0554
  • Fax: 318-624-3782
Mailing address:
  • Phone: 318-927-2306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN097166 AP03441
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: