Healthcare Provider Details

I. General information

NPI: 1407262249
Provider Name (Legal Business Name): NICOLA PIAZZA KENT APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLA SILVANA PIAZZA APRN, FNP

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 S VIENNA ST
RUSTON LA
71270-5845
US

IV. Provider business mailing address

707 S VIENNA ST
RUSTON LA
71270-5845
US

V. Phone/Fax

Practice location:
  • Phone: 318-224-3044
  • Fax: 318-232-2978
Mailing address:
  • Phone: 318-224-3044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07820
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: