Individual
MRS. LISA MARIE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC, FNP-BC
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN108838
LA
363L00000X
Nurse Practitioner
AP07987
LA
363LA2100X
Acute Care Nurse Practitioner
AP07987
LA
363LF0000X
Family Nurse Practitioner
AP07987
LA
363LG0600X
Gerontology Nurse Practitioner
Primary
AP07987
LA
Other
Enumeration date
07/31/2014
Last updated
10/25/2023
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