Healthcare Provider Details

I. General information

NPI: 1154053205
Provider Name (Legal Business Name): AMY ELIZABETH HULSEY APRN, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 STATE ST
JENNINGS LA
70546-4739
US

IV. Provider business mailing address

805 STATE ST
JENNINGS LA
70546-4739
US

V. Phone/Fax

Practice location:
  • Phone: 337-824-6150
  • Fax:
Mailing address:
  • Phone: 337-824-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number226269
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: