Provider Demographics
NPI:1306287784
Name:GARRETT, ASHLEY D'ANNA (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D'ANNA
Last Name:GARRETT
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 1:1449 E BERT KOUNS LOOP
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5663
Mailing Address - Country:US
Mailing Address - Phone:318-629-0220
Mailing Address - Fax:318-629-0230
Practice Address - Street 1:1449 E BERT KOUNS LOOP
Practice Address - Street 2:SUITE 100
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5663
Practice Address - Country:US
Practice Address - Phone:318-629-0220
Practice Address - Fax:318-629-0230
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily