Provider Demographics
NPI:1639672777
Name:DAKOTA FAMILY HEALTHCARE, LLC
Entity Type:Organization
Organization Name:DAKOTA FAMILY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP
Authorized Official - Phone:337-423-6695
Mailing Address - Street 1:PO BOX 293
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:LA
Mailing Address - Zip Code:70639-0293
Mailing Address - Country:US
Mailing Address - Phone:337-423-6695
Mailing Address - Fax:
Practice Address - Street 1:601 S PINE ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-4941
Practice Address - Country:US
Practice Address - Phone:337-462-9919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09743363LF0000X, 363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchoolGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty