Healthcare Provider Details

I. General information

NPI: 1861564809
Provider Name (Legal Business Name): CADDO PARISH SCHOOL BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 W 70TH ST
SHREVEPORT LA
71129-2630
US

IV. Provider business mailing address

5800 W 70TH ST
SHREVEPORT LA
71129-2630
US

V. Phone/Fax

Practice location:
  • Phone: 318-687-4220
  • Fax: 318-687-4362
Mailing address:
  • Phone: 318-687-4220
  • Fax: 318-687-4362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRIDGET SHARON CAUSEY
Title or Position: RN BSN
Credential:
Phone: 318-687-4220