Healthcare Provider Details

I. General information

NPI: 1437774635
Provider Name (Legal Business Name): APRIL CHASE ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 ALBERT L BICKNELL DR STE 5C
SHREVEPORT LA
71103-3943
US

IV. Provider business mailing address

2751 ALBERT L BICKNELL DR STE 5C
SHREVEPORT LA
71103-3943
US

V. Phone/Fax

Practice location:
  • Phone: 318-227-9777
  • Fax:
Mailing address:
  • Phone: 318-277-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number213761
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number213761
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number213761
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: