Basic Information
| Provider Information | |||||||||
| NPI: | 1417439415 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALESHIA MCGLOTHLIN LOUISIANA HEALTH & WELLNESS CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1403 METRO DR STE G-2 | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713013454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3187879038 | ||||||||
| FaxNumber: | 3182667974 | ||||||||
| Practice Location | |||||||||
| Address1: | 1403 METRO DR STE G-2 | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713013454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3187879038 | ||||||||
| FaxNumber: | 3182667974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2018 | ||||||||
| LastUpdateDate: | 06/15/2020 | ||||||||
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| AuthorizedOfficialLastName: | MCGLOTHLIN | ||||||||
| AuthorizedOfficialFirstName: | ALESHIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3187879038 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | FNP | ||||||||
| NPICertificationDate: | 06/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LF0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.