Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 211926 | LA |
NPI | 1093349078 |
---|---|
Provider Name | Alysha Hinson |
First Address | Shreveport, LA 71105-6000 |
Second Address | Shreveport, LA 71105-5634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2020 |
Last Update Date | 27/02/2020 |