Individual
MISTY MARLENE ANTHONY-MCALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPAS
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
300091
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0246933
CIGNA
—
01
—
13653665
CAQH
—
01
—
146475
VANTAGE HEALTH PLAN
—
01
—
1740646355
LA HEALTHCARE CONNECTIONS
LA
01
—
1740646355
HEALTHY BLUE
—
05
—
2424076
—
LA
01
—
2645976
WELLCARE
—
01
—
2869917
FIRST HEALTH
—
01
—
60326536
AMERIHEALTH CARITAS
LA
01
—
6261862
AETNA
—
01
—
7771259
MULTIPLAN (PHCS)
—
01
—
QZZ000000106926
AETNA BETTER HEALTH
—
Enumeration date
01/12/2016
Last updated
04/22/2024
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