Individual
MS. HAILEY CHEATWOOD TEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
2727 HEARNE AVE STE 301, SHREVEPORT, LA 71103-3918
(318) 631-6400
(318) 631-0300
Mailing address
2727 HEARNE AVE STE 301, SHREVEPORT, LA 71103-3918
(186) 316-4003
(318) 631-0300
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
220615
LA
363LA2200X
Adult Health Nurse Practitioner
220615
LA
363LG0600X
Gerontology Nurse Practitioner
220615
LA
Other
Enumeration date
06/29/2021
Last updated
07/20/2022
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