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General NPI Number Information
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NPI Number | 1013836386
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Entity Type | Organization
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Legal Business Name | H.E.R. INTEGRATIVE WELLNESS LLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 2924 KNIGHT ST BLDG 3
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City | SHREVEPORT
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State | LA
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Zip | 71105-2415
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Country | US
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Telephone | 318-506-4245
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Fax | 855-631-0063
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Provider Business Mailing Address
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Address Line | 2924 KNIGHT ST STE 357
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City | SHREVEPORT
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State | LA
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Zip | 71105-2413
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Country | US
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Telephone | 318-506-4245
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Fax | 855-631-0063
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Authorized Official
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Title or Position | OWNER
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Name | BRIDGET ODOM LEE
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Credential | NURSE PRACTITIONER
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Telephone | 318-564-7023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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