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General NPI Number Information
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NPI Number | 1063992238
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Entity Type | Individual
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Provider Name | MS. ALESHA N KINGSBY
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Gender | Female
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Dates
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Enumeration Date | 08/17/2018
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 653 W 70TH ST
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City | SHREVEPORT
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State | LA
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Zip | 71106-2949
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Country | US
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Telephone | 318-636-8389
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Fax | 318-319-2151
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Provider Business Mailing Address
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Address Line | 653 W 70TH ST
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City | SHREVEPORT
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State | LA
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Zip | 71106-2949
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Country | US
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Telephone | 318-636-8389
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Fax | 318-319-2151
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP200083
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06181386
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License Number State | LA
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