Provider Demographics
NPI:1215917513
Name:GARCIE, AMY MARIE (NP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:GARCIE
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 1:1015 OBRIE ST
Mailing Address - Street 2:
Mailing Address - City:ZWOLLE
Mailing Address - State:LA
Mailing Address - Zip Code:71486-2510
Mailing Address - Country:US
Mailing Address - Phone:318-645-6161
Mailing Address - Fax:318-645-6168
Practice Address - Street 1:1015 OBRIE ST
Practice Address - Street 2:
Practice Address - City:ZWOLLE
Practice Address - State:LA
Practice Address - Zip Code:71486-2510
Practice Address - Country:US
Practice Address - Phone:318-645-6161
Practice Address - Fax:318-645-6168
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA078776163W00000X
LA04127363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1149811Medicaid
4C485C891Medicare ID - Type Unspecified
LA1149811Medicaid