Individual
CALLIE ANN HATHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, ACNPC-AG
Contact information
Practice address
2551 GREENWOOD RD STE 140, SHREVEPORT, LA 71103-3984
(318) 212-8899
Mailing address
2551 GREENWOOD RD STE 140, SHREVEPORT, LA 71103-3984
(318) 212-8899
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
236634
LA
363LF0000X
Family Nurse Practitioner
Primary
236634
LA
Other
Enumeration date
08/14/2024
Last updated
12/31/2025
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