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Organization

PROVISION HEALTH CARE LLC

Active
Other names
Family Convenience Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
KATELYN J TAYLOR FNP-C (OWNER)
(318) 322-9252
Entity
Organization

Contact information

Practice address
2933 CYPRESS ST STE 1, HALL B, WEST MONROE, LA 71291-5468
(318) 322-3637
Mailing address
PO BOX 510, WEST MONROE, LA 71294-0510
(318) 322-9252

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2607090
LA
01
2N6054
MEDICARE
LA
Enumeration date
07/18/2022
Last updated
02/02/2026
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