Provider Demographics
NPI:1851735237
Name:ADVANCED PRACTICE PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:ADVANCED PRACTICE PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:318-843-0908
Mailing Address - Street 1:PO BOX 258
Mailing Address - Street 2:
Mailing Address - City:GIBSLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71028-0258
Mailing Address - Country:US
Mailing Address - Phone:318-843-0908
Mailing Address - Fax:
Practice Address - Street 1:775 FIRST ST
Practice Address - Street 2:
Practice Address - City:GIBSLAND
Practice Address - State:LA
Practice Address - Zip Code:71028
Practice Address - Country:US
Practice Address - Phone:318-843-0908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN107298- AP05586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty