Individual
MISS COLLEEN HANNON CLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8383 MILLICENT WAY, SHREVEPORT, LA 71115-5207
(318) 797-6661
(318) 795-8512
Mailing address
8383 MILLICENT WAY, SHREVEPORT, LA 71115-5207
(318) 797-6661
(318) 795-8503
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA07541
TX
363A00000X
Physician Assistant
Primary
PA200506
LA
Other
Enumeration date
10/31/2011
Last updated
12/19/2017
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