Provider Demographics
NPI:1639239957
Name:OFFICE OF PUBLIC HEALTH-NHV PROGRAM-REGION 8
Entity Type:Organization
Organization Name:OFFICE OF PUBLIC HEALTH-NHV PROGRAM-REGION 8
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGION 8 NFP SUPERVISOR-PHN-5
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:318-361-7215
Mailing Address - Street 1:1650 DESIARD ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7722
Mailing Address - Country:US
Mailing Address - Phone:318-361-7215
Mailing Address - Fax:318-362-3163
Practice Address - Street 1:1650 DESIARD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7722
Practice Address - Country:US
Practice Address - Phone:318-361-7215
Practice Address - Fax:318-362-3163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACM 9913251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1567141Medicaid