Individual
MRS. MARY TILLMAN ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
8001 YOUREE DR STE 300, SHREVEPORT, LA 71115-2303
(318) 212-3800
(318) 212-3805
Mailing address
8001 YOUREE DR STE 320, SHREVEPORT, LA 71115-2354
(318) 212-2870
(318) 212-2875
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP07973
LA
Other
Enumeration date
07/24/2014
Last updated
07/06/2021
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