Healthcare Provider Details

I. General information

NPI: 1003783770
Provider Name (Legal Business Name): PROHEALTH MONROE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2025
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 CHARTRES CIR
MONROE LA
71201-3671
US

IV. Provider business mailing address

1721 CHARTRES CIR
MONROE LA
71201-3671
US

V. Phone/Fax

Practice location:
  • Phone: 318-537-3056
  • Fax:
Mailing address:
  • Phone: 318-537-3056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KANDICE NICOLE HUNTER
Title or Position: OWNER/MANAGING MEMBER
Credential: AGNP-C, FNP-C
Phone: 318-537-3056