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NPI Code Detail

MEDICARE: MRS. EMILY D SPARKS CRNA

MEDICARE: MRS. EMILY D SPARKS CRNA
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
1163W00000XRegistered Nurse1022724TX
2390200000XStudent in an Organized Health Care Education/Training Program
3367500000XCertified Registered Nurse Anesthetist245357LA

General Provider Information

NPI Number : 1417749490
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY D SPARKS CRNA
Provider Business Mailing Address
First Line : 7777 HENNESSY BLVD STE 301
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-0319
Country : US
Telephone Number : 225-214-6438
Fax Number :
Provider Business Practice Location Address
First Line : 5000 HENNESSY BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4375
Country : US
Telephone Number : 225-214-6438
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2025
Last Update Date : 01/22/2026

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