Healthcare Provider Details

I. General information

NPI: 1427912286
Provider Name (Legal Business Name): ANTOINETTE QUARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5906 N MARKET ST
SHREVEPORT LA
71107-2014
US

IV. Provider business mailing address

5906 N MARKET ST
SHREVEPORT LA
71107-2014
US

V. Phone/Fax

Practice location:
  • Phone: 318-309-5008
  • Fax: 318-309-5012
Mailing address:
  • Phone: 318-309-5008
  • Fax: 318-309-5012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN108358
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: