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General NPI Number Information
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NPI Number | 1275800344
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Entity Type | Individual
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Provider Name | ALICIA DIANE SCHOLLMEYER FNP
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Gender | Female
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 2600 KINGS HWY STE 200
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City | SHREVEPORT
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State | LA
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Zip | 71103-3951
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Country | US
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Telephone | 318-212-8620
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 KINGS HWY STE 200
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City | SHREVEPORT
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State | LA
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Zip | 71103-3951
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Country | US
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Telephone | 318-212-8620
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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 | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | 208047
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | 208047
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 208047
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License Number State | LA
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