Provider Demographics
NPI:1811778996
Name:HERKE, CLAIRE (PA)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:HERKE
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3217 MABEL ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-4022
Mailing Address - Country:US
Mailing Address - Phone:183-631-9121
Mailing Address - Fax:318-629-1445
Practice Address - Street 1:8383 MILLICENT WAY STE B
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-5207
Practice Address - Country:US
Practice Address - Phone:318-631-9121
Practice Address - Fax:318-213-6246
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA339129363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical