Healthcare Provider Details

I. General information

NPI: 1083960587
Provider Name (Legal Business Name): NANCY BOURN ADKINS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 07/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 MORRIS DR
MINDEN LA
71055-3053
US

IV. Provider business mailing address

208 MORRIS DR
MINDEN LA
71055-3053
US

V. Phone/Fax

Practice location:
  • Phone: 318-377-8260
  • Fax:
Mailing address:
  • Phone: 318-377-8260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP06971
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: