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NPI Code Detail

MEDICARE: KELLY L TOUPS APRN-BC

MEDICARE: KELLY L TOUPS APRN-BC
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 PractitionerAP04292LA

Other Identifiers

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

General Provider Information

NPI Number : 1912976614
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY L TOUPS APRN-BC
Provider Business Mailing Address
First Line : 152 SAND BEACH BLVD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-4504
Country : US
Telephone Number : 318-401-6709
Fax Number :
Provider Business Practice Location Address
First Line : 152 SAND BEACH BLVD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-4504
Country : US
Telephone Number : 318-401-6709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 09/30/2021

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Directions to “ KELLY L TOUPS APRN-BC” Practice Location

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