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General NPI Number Information
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NPI Number | 1043979248
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Entity Type | Individual
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Provider Name | CHRISTY LEMON FNP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 1453 E BERT KOUNS INDUSTRIAL LOOP
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City | SHREVEPORT
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State | LA
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Zip | 71105-6800
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Country | US
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Telephone | 318-681-4138
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Fax |
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Provider Business Mailing Address
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Address Line | 7585 HIGHWAY 1
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City | SHREVEPORT
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State | LA
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Zip | 71107-8146
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Country | US
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Telephone | 318-572-1368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 222239
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License Number State | LA
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