Provider Demographics
NPI:1437769817
Name:POSEY, FELICIA ARDELL
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ARDELL
Last Name:POSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N THOMAS DR STE 14
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-6555
Mailing Address - Country:US
Mailing Address - Phone:318-219-5779
Mailing Address - Fax:318-219-5780
Practice Address - Street 1:200 N THOMAS DR STE 14
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-6555
Practice Address - Country:US
Practice Address - Phone:318-219-5779
Practice Address - Fax:318-219-5780
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA124Q00000X, 126800000X, 146D00000X, 156F00000X, 174H00000X, 174400000X
221700000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No124Q00000XDental ProvidersDental Hygienist
No126800000XDental ProvidersDental Assistant
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No156F00000XEye and Vision Services ProvidersTechnician/Technologist
No174H00000XOther Service ProvidersHealth Educator
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant