Provider Demographics
NPI:1417439415
Name:ALESHIA MCGLOTHLIN LOUISIANA HEALTH & WELLNESS CENTER
Entity Type:Organization
Organization Name:ALESHIA MCGLOTHLIN LOUISIANA HEALTH & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGLOTHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:318-787-9038
Mailing Address - Street 1:1403 METRO DR STE G-2
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3454
Mailing Address - Country:US
Mailing Address - Phone:318-787-9038
Mailing Address - Fax:318-266-7974
Practice Address - Street 1:1403 METRO DR STE G-2
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3454
Practice Address - Country:US
Practice Address - Phone:318-787-9038
Practice Address - Fax:318-266-7974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty