Healthcare Provider Details

I. General information

NPI: 1922130475
Provider Name (Legal Business Name): MYRA FIELDS VARNADO BS RN CDE CWOCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52579 HIGHWAY 51 S
INDEPENDENCE LA
70443-2231
US

IV. Provider business mailing address

PO BOX 703
ROSELAND LA
70456-0703
US

V. Phone/Fax

Practice location:
  • Phone: 985-878-1341
  • Fax: 985-878-1342
Mailing address:
  • Phone: 985-878-1341
  • Fax: 985-878-1342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number45988
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163WE0900X
TaxonomyEnterostomal Therapy Registered Nurse
License Number45988
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number45988
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: