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NPI Code Detail

MEDICARE: MR. JOHN R MASSEY NURSE PRACTITIONER

MEDICARE:  MR. JOHN R MASSEY  NURSE PRACTITIONER
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
1364SF0001XFamily Health Clinical Nurse Specialist1660LA

General Provider Information

NPI Number : 1184823676
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN R MASSEY NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 604 BELUE LANE
Second Line : SUITE B
City : RUSTON
State : LA
Zip : 71270-8299
Country : US
Telephone Number : 318-251-6385
Fax Number :
Provider Business Practice Location Address
First Line : 604 BELUE LANE
Second Line : SUITE B
City : RUSTON
State : LA
Zip : 71270-5936
Country : US
Telephone Number : 318-251-6385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2007
Last Update Date : 07/16/2007

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Directions to “ MR. JOHN R MASSEY NURSE PRACTITIONER” Practice Location

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