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NPI Code Detail

MEDICARE: MS. ROSALINE MICHELLE DARTY AP NP

MEDICARE: MS. ROSALINE MICHELLE DARTY AP NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0200XPediatric Registered NurseAP04803LA
2363LP0200XPediatric Nurse PractitionerRN088507-AP04803LA
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAP04803LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164430526
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSALINE MICHELLE DARTY AP NP
Provider Business Mailing Address
First Line : 2508 BERT KOUNS INDUSTRIAL LOOP
Second Line :
City : SHREVEPORT
State : LA
Zip : 71118-3133
Country : US
Telephone Number : 318-212-5880
Fax Number : 318-212-5885
Provider Business Practice Location Address
First Line : 1625 DAVID RAINES RD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-5899
Country : US
Telephone Number : 318-425-2252
Fax Number : 318-425-2367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 03/19/2024

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