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NPI Code Detail

MEDICARE: D'ANDRIA MONIQUE DOUGLAS

MEDICARE: D'ANDRIA MONIQUE DOUGLAS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1710834932
Entity Type Code : Individual
Provider Name (Legal Business Name) : D'ANDRIA MONIQUE DOUGLAS
Provider Business Mailing Address
First Line : 1000 CHINABERRY DR
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-2442
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1301 YOUREE DR
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-5117
Country : US
Telephone Number : 318-675-0804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ D'ANDRIA MONIQUE DOUGLAS ” Practice Location

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