# UNITED STATES AIRFORCE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942549092
- **Authorized official:** MRS. JESSICA HELEN MAHAN RN (NURSE PRACTITIONER)
- **Authorized official phone:** (318) 235-9300

## Contact information

- **Practice address:** 1801 N 5TH ST, MONROE, LA 71201-4245
- **Practice address phone:** (318) 235-9300
- **Mailing address:** 1801 N 5TH ST, MONROE, LA 71201-4245
- **Mailing address phone:** (318) 235-9300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WE0003X | Emergency Registered Nurse | 119937 | LA | Yes |

## Other

- **Enumeration date:** 02/10/2013
- **Last updated:** 02/10/2013