Healthcare Provider Details

I. General information

NPI: 1609354869
Provider Name (Legal Business Name): TERRI A PIZANIE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRI A WELLS FNP-C

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9465 US HIGHWAY 165
POLLOCK LA
71467-3511
US

IV. Provider business mailing address

PO BOX 1288
WINNFIELD LA
71483-1288
US

V. Phone/Fax

Practice location:
  • Phone: 318-310-2510
  • Fax:
Mailing address:
  • Phone: 318-209-4510
  • Fax: 318-209-4519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10178
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: