Provider Demographics
NPI:1477848380
Name:FLORICE, CHRISTAL S (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTAL
Middle Name:S
Last Name:FLORICE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-4535
Mailing Address - Country:US
Mailing Address - Phone:318-574-4731
Mailing Address - Fax:318-574-4739
Practice Address - Street 1:800 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-4535
Practice Address - Country:US
Practice Address - Phone:318-574-4731
Practice Address - Fax:318-574-4739
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR861534363LF0000X
LAAP06476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily