Healthcare Provider Details

I. General information

NPI: 1114449071
Provider Name (Legal Business Name): AARON STIGERS AGNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 07/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2551 GREENWOOD RD STE 220
SHREVEPORT LA
71103-3985
US

IV. Provider business mailing address

318 SHORT LEAF DR
HAUGHTON LA
71037-9505
US

V. Phone/Fax

Practice location:
  • Phone: 318-635-9855
  • Fax: 318-635-9857
Mailing address:
  • Phone: 318-426-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP09482
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: