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General NPI Number Information
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NPI Number | 1376835694
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Entity Type | Individual
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Provider Name | MANDIE CLOUD PNP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 5416 HIGHWAY 28 E
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City | PINEVILLE
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State | LA
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Zip | 71360
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Country | US
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Telephone | 318-545-7334
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Fax | 318-704-6140
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Provider Business Mailing Address
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Address Line | 5416 HIGHWAY 28 E
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City | PINEVILLE
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State | LA
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Zip | 71360-4756
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Country | US
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Telephone | 318-545-7334
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Fax | 318-704-6140
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 06446
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP06446
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | AP06446
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License Number State | LA
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