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NPI Code Detail

MEDICARE: MONTRICE HARTWELL

MEDICARE: MONTRICE HARTWELL
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
1363LF0000XFamily Nurse Practitioner215288LA

General Provider Information

NPI Number : 1184331639
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONTRICE HARTWELL
Provider Business Mailing Address
First Line : 8445 LINE AVE STE 100
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-5925
Country : US
Telephone Number : 318-690-5129
Fax Number :
Provider Business Practice Location Address
First Line : 8445 LINE AVE STE 100
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-5925
Country : US
Telephone Number : 318-690-5129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2022
Last Update Date : 01/20/2026

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Directions to “ MONTRICE HARTWELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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