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NPI Code Detail

MEDICARE: JERRY A STALLINGS ARNP, FNP

MEDICARE: JERRY A STALLINGS ARNP, FNP
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 PractitionerAP05589LA

General Provider Information

NPI Number : 1669623609
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY A STALLINGS ARNP, FNP
Provider Business Mailing Address
First Line : 9372 HIGHWAY 165 S
Second Line :
City : WOODWORTH
State : LA
Zip : 71485-9786
Country : US
Telephone Number : 318-484-9588
Fax Number :
Provider Business Practice Location Address
First Line : 9372 HIGHWAY 165 S
Second Line :
City : WOODWORTH
State : LA
Zip : 71485-9786
Country : US
Telephone Number : 318-484-9588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2008
Last Update Date : 06/20/2023

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