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NPI 1770916090

NPI 1770916090 : PASHALA PERRY FNP-C : SHREVEPORT, LA

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General NPI Number Information
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    NPI Number           |    1770916090
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    Entity Type          |    Individual 
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    Provider Name        |    PASHALA PERRY FNP-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/11/2013
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    Last Update Date     |    12/11/2025
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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                  |    985-892-7017
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    AP07517
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    License Number State |    LA
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Taxonomy #2
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    AP124669
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    License Number State |    TX
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