Provider Demographics
NPI:1912292301
Name:LOUISIANA HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:LOUISIANA HEALTH CARE SERVICES, LLC
Other - Org Name:HEALTH CARE SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:SHE'REE
Authorized Official - Last Name:CULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN,MSN,FNP-BC, DNP
Authorized Official - Phone:225-337-5792
Mailing Address - Street 1:3913 LAKE LAROUGE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-7315
Mailing Address - Country:US
Mailing Address - Phone:225-337-5792
Mailing Address - Fax:
Practice Address - Street 1:3913 LAKE LAROUGE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-7315
Practice Address - Country:US
Practice Address - Phone:225-337-5792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251300000X
LARN104218251J00000X
LAAP05089261QH0100X, 363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No251300000XAgenciesLocal Education Agency (LEA)
No251J00000XAgenciesNursing Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1466387Medicaid