MEDICARE: LOUISIANA HEALTH CARE SERVICES, LLC

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	251300000X	Local Education Agency (LEA)		LA
2	251J00000X	Nursing Care Agency	RN104218	LA
3	261QH0100X	Health Service Clinic/Center	AP05089	LA
4	363LF0000X	Family Nurse Practitioner	AP05089	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	:	1912292301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISIANA HEALTH CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	3913 LAKE LAROUGE DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-7315
Country	:	US
Telephone Number	:	225-337-5792
Fax Number	:

Provider Business Practice Location Address
First Line	:	3913 LAKE LAROUGE DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-7315
Country	:	US
Telephone Number	:	225-337-5792
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	LEAH SHE'REE CULLINS
Credential	:	APRN,MSN,FNP-BC, DNP
Telephone Number	:	225-337-5792

Provider Enumeration Date	:	06/14/2011
Last Update Date	:	10/15/2022

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