Individual
MRS. ALECIA C. CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
2104 LOOP RD STE C, WINNSBORO, LA 71295-3341
(318) 435-4571
Mailing address
PO BOX 1300, WINNSBORO, LA 71295-1300
(318) 435-9411
(225) 765-9244
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP05271
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1143235
—
LA
01
—
12494267
CAQH
—
01
—
3C893
MEDICARE
LA
01
—
P02474561
RR MEDICARE
LA
Enumeration date
09/11/2007
Last updated
04/07/2021
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