MED ONE HEALTH CLINIC, LLC
NPI 1609681345
Nurse Practitioner - Primary Care in Haughton, LA
Active since February 10, 2025
About Med One Health Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MED ONE HEALTH CLINIC, LLC (NPI 1609681345) is a healthcare organization registered as a primary care in Haughton, Louisiana and active in the NPI registry since February 2025. The organization lists Latrisala Bankston, Owner, as its authorized official.
NPPES Registry Identity
NPI1609681345
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameMED ONE HEALTH CLINIC, LLC
Location Address349 DOGWOOD SOUTH LNHaughton, LA 71037-8511
Mailing Address349 Dogwood South LnHaughton, LA 71037-8511
Phone(832) 870-8375
Organization SubpartNo
Authorized OfficialLatrisala BankstonOwner · (832) 870-8375
Enumeration DateFebruary 10, 2025
Last NPPES UpdateFebruary 12, 2025
NPPES CertifiedFebruary 12, 2025
✔ NPI 1609681345 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
349 DOGWOOD SOUTH LN, Haughton, LA 71037
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609681345, enumerated as an "organization" on February 10, 2025.
The provider is located at 349 DOGWOOD SOUTH LN HAUGHTON, LA 71037 and the phone number is (832) 870-8375.
Nurse Practitioner with taxonomy code 363LP2300X and a focus in Primary Care.
