MEDICARE: CLOUD MIND

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1962368795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOUD MIND

Provider Business Mailing Address
First Line	:	9030 NEWCASTLE DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71129-5122
Country	:	US
Telephone Number	:	318-616-1013
Fax Number	:

Provider Business Practice Location Address
First Line	:	9030 NEWCASTLE DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71129-5122
Country	:	US
Telephone Number	:	318-616-1013
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIFFANY CARR
Credential	:	PMHNP
Telephone Number	:	318-780-2089

Provider Enumeration Date	:	12/24/2025
Last Update Date	:	12/24/2025

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Directions to “CLOUD MIND ” Practice Location

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