Individual
PRISCILLA IHENACHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 HOLIDAY BLVD, SUITE 100, SHREVEPORT, LA 71103-4228
(945) 941-0704
(888) 338-1461
Mailing address
205 HOLIDAY BLVD, SUITE 100 PMB, SHREVEPORT, LA 71103-4228
(945) 941-0704
(888) 338-1461
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
341726
LA
207R00000X
Internal Medicine Physician
46868
OK
207R00000X
Internal Medicine Physician
W3958
TX
Other
Enumeration date
05/20/2021
Last updated
04/14/2026
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