Provider Demographics
NPI:1083014229
Name:MCVAY, ALISHA (NP-C)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:MCVAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-3002
Mailing Address - Country:US
Mailing Address - Phone:318-878-3737
Mailing Address - Fax:318-878-9682
Practice Address - Street 1:508 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-3002
Practice Address - Country:US
Practice Address - Phone:318-878-3737
Practice Address - Fax:318-878-9682
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2379712Medicaid