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General NPI Number Information
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NPI Number | 1316686520
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Entity Type | Individual
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Provider Name | KENDRA WOMACK HALSELL APRN
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Gender | Female
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Dates
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Enumeration Date | 06/04/2022
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 1801 FAIRFIELD AVE STE 408
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City | SHREVEPORT
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State | LA
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Zip | 71101-4468
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Country | US
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Telephone | 318-239-7045
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Fax | 318-585-0026
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | HAMMOND
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State | LA
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Zip | 70404-1089
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Country | US
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Telephone | 985-892-7070
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Fax | 800-878-1442
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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 | 225873
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License Number State | LA
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