Provider Demographics
NPI:1316686520
Name:HALSELL, KENDRA WOMACK (APRN)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:WOMACK
Last Name:HALSELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1089
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1089
Mailing Address - Country:US
Mailing Address - Phone:985-892-7070
Mailing Address - Fax:800-878-1442
Practice Address - Street 1:1801 FAIRFIELD AVE STE 408
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4468
Practice Address - Country:US
Practice Address - Phone:318-239-7045
Practice Address - Fax:318-585-0026
Is Sole Proprietor?:No
Enumeration Date:2022-06-04
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA225873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily