Individual
MRS. DIANNA ELIZABETH FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
246 ATLANTIC AVE, SHREVEPORT, LA 71105-3027
(318) 294-6337
Mailing address
246 ATLANTIC AVE, SHREVEPORT, LA 71105-3027
(318) 294-6337
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
Primary
RN158038
LA
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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