Individual
AMITA PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2727 HEARNE AVE, SHREVEPORT, LA 71103-3917
(318) 631-6400
Mailing address
607 LABARRE LN, BOSSIER CITY, LA 71111-6433
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
218958
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
218958
APRN LICENSE
LA
Enumeration date
12/22/2021
Last updated
12/22/2021
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