Healthcare Provider Details

I. General information

NPI: 1356608921
Provider Name (Legal Business Name): LIVIA TRUELOVE ZALEWSKI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 MEDICAL PARK DRIVE SUITE 9
MONROE LA
71203
US

IV. Provider business mailing address

201 FRENCHMANS BEND PLACE
MONROE LA
71203
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-6050
  • Fax:
Mailing address:
  • Phone: 318-547-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP06814
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: