Provider Demographics
NPI:1194105478
Name:MCGLOTHLIN, ALESHIA DEMENT (NP)
Entity type:Individual
Prefix:
First Name:ALESHIA
Middle Name:DEMENT
Last Name:MCGLOTHLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 METRO DR BLDG STE G-2
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3454
Mailing Address - Country:US
Mailing Address - Phone:318-787-9038
Mailing Address - Fax:318-266-7974
Practice Address - Street 1:1403 METRO DR BLDG STE G-2
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3454
Practice Address - Country:US
Practice Address - Phone:318-787-9038
Practice Address - Fax:318-266-7974
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08288363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health