Provider Demographics
NPI:1922151000
Name:HOOD, MARY ELLEN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELLEN
Last Name:HOOD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 380
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-0380
Mailing Address - Country:US
Mailing Address - Phone:318-346-7283
Mailing Address - Fax:318-346-9859
Practice Address - Street 1:109 N LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1619
Practice Address - Country:US
Practice Address - Phone:318-346-7283
Practice Address - Fax:318-346-9859
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA363LF0000X363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1437816Medicaid
LA1437816Medicaid
LA4B649Medicare PIN