Healthcare Provider Details

I. General information

NPI: 1801243159
Provider Name (Legal Business Name): FAMILY FIRST HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL PLAZA PL
MINDEN LA
71055-3330
US

IV. Provider business mailing address

2 MEDICAL PLAZA PL
MINDEN LA
71055-3330
US

V. Phone/Fax

Practice location:
  • Phone: 318-377-8400
  • Fax: 318-377-8641
Mailing address:
  • Phone: 318-377-8400
  • Fax: 318-377-8641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. LILLIAN LEIGH DAVIS
Title or Position: OWNER/NURSE PRACTITIONER
Credential: APRN, FNP-C
Phone: 318-377-8400