Provider Demographics
NPI:1326882754
Name:CHILDS, KAMARIE LEANN (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KAMARIE
Middle Name:LEANN
Last Name:CHILDS
Suffix:
Gender:F
Credentials:WHNP-BC
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Mailing Address - Street 1:2006 WOODBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-8565
Mailing Address - Country:US
Mailing Address - Phone:318-773-5531
Mailing Address - Fax:318-841-5817
Practice Address - Street 1:2401 GREENWOOD RD STE A
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-4010
Practice Address - Country:US
Practice Address - Phone:318-841-5800
Practice Address - Fax:318-841-5817
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA236031363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health