Healthcare Provider Details

I. General information

NPI: 1942714324
Provider Name (Legal Business Name): VARAKA NESHEA RHONE RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10003 CARLSBAD DR
SHREVEPORT LA
71115-3424
US

IV. Provider business mailing address

10003 CARLSBAD DR
SHREVEPORT LA
71115-3424
US

V. Phone/Fax

Practice location:
  • Phone: 318-347-2650
  • Fax:
Mailing address:
  • Phone: 318-347-2650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN126194
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: