Healthcare Provider Details

I. General information

NPI: 1982181301
Provider Name (Legal Business Name): MEGAN K ATKINSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 HEARNE AVE STE 301
SHREVEPORT LA
71103-3918
US

IV. Provider business mailing address

232 AVONDALE LN
BOSSIER CITY LA
71112-4265
US

V. Phone/Fax

Practice location:
  • Phone: 318-631-6400
  • Fax:
Mailing address:
  • Phone: 318-617-9715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10171
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: