Provider Demographics
NPI:1982181301
Name:ATKINSON, MEGAN K (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 AVONDALE LN
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4265
Mailing Address - Country:US
Mailing Address - Phone:318-617-9715
Mailing Address - Fax:
Practice Address - Street 1:2727 HEARNE AVE STE 301
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3918
Practice Address - Country:US
Practice Address - Phone:318-631-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP10171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily