Healthcare Provider Details

I. General information

NPI: 1740811801
Provider Name (Legal Business Name): MAGAHN WARD STANGA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 06/26/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27124 HIGHWAY 42
SPRINGFIELD LA
70462
US

IV. Provider business mailing address

20035 LA HIGHWAY 444
LIVINGSTON LA
70754-5018
US

V. Phone/Fax

Practice location:
  • Phone: 225-395-8022
  • Fax: 225-395-8023
Mailing address:
  • Phone: 225-252-0884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number211493
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: