Provider Demographics
NPI:1942379649
Name:FLORICE, JOE C (FNP)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:C
Last Name:FLORICE
Suffix:
Gender:M
Credentials:FNP
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 1300
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-1300
Mailing Address - Country:US
Mailing Address - Phone:318-435-9411
Mailing Address - Fax:
Practice Address - Street 1:448 NEWTON ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:LA
Practice Address - Zip Code:71366-4330
Practice Address - Country:US
Practice Address - Phone:318-766-8506
Practice Address - Fax:318-435-7458
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3A019OtherMEDICARE
LA12206864OtherCAQH
LA1454346Medicaid
LAP02474662OtherRR MEDICARE