Individual
HOLLY RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2520 BERT KOUNS INDUSTRIAL LOOP, SUITE 105, SHREVEPORT, LA 71118-3130
(318) 212-5520
(318) 212-5540
Mailing address
2520 BERT KOUNS INDUSTRIAL LOOP, SUITE 105, SHREVEPORT, LA 71118-3130
(318) 212-5520
(318) 212-5540
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP08449
LA
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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