MEDICARE: MRS. TAHEERA FORBES FNP-C

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
1	363LF0000X	Family Nurse Practitioner	202037	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821561739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAHEERA FORBES FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 1089
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70404-1089
Country	:	US
Telephone Number	:	985-892-7070
Fax Number	:	855-821-4499

Provider Business Practice Location Address
First Line	:	102 S MONROE ST STE B
Second Line	:
City	:	MINDEN
State	:	LA
Zip	:	71055-3357
Country	:	US
Telephone Number	:	318-232-6835
Fax Number	:	318-639-9245

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2019
Last Update Date	:	02/07/2022

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