Individual
MRS. ALICIA MINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, CCHC, CBS, CBE,
Contact information
Practice address
9250 DEAN RD APT 2112, SHREVEPORT, LA 71118-2851
(318) 219-6640
Mailing address
2400 TEXAS AVE UNIT 38602, SHREVEPORT, LA 71133-5116
(318) 219-6640
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20160175
LA
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
374J00000X
Doula
—
LA
Other
Enumeration date
03/16/2021
Last updated
09/20/2021
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