Provider Demographics
NPI:1265114136
Name:PATEL, SACHA (FNP-C)
Entity type:Individual
Prefix:
First Name:SACHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 BERT KOUNS INDUSTRIAL LOOP STE 101
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3175
Mailing Address - Country:US
Mailing Address - Phone:318-212-5811
Mailing Address - Fax:318-212-5844
Practice Address - Street 1:2508 BERT KOUNS INDUSTRIAL LOOP STE 101
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3175
Practice Address - Country:US
Practice Address - Phone:318-212-5811
Practice Address - Fax:318-212-5844
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA215371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily