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General NPI Number Information
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NPI Number | 1730901398
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Entity Type | Individual
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Provider Name | OLIVIA CARTER HARRIS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 160 STONE CREEK RD STE A
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City | STONEWALL
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State | LA
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Zip | 71078-4906
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Country | US
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Telephone | 318-925-3339
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Fax | 318-747-8150
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Provider Business Mailing Address
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Address Line | 2539 VIKING DR STE 101
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City | BOSSIER CITY
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State | LA
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Zip | 71111-2165
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Country | US
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Telephone | 318-747-8100
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Fax | 318-747-8150
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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 | 237538
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License Number State | LA
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