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MAGNOLIA DIAGNOSTIC SERVICES INC.
NPI 1770375768
Nurse Practitioner in Shreveport, LA

Active since May 19, 2025
4005 LAKESHORE DR, SHREVEPORT, LA 71109(318) 840-9074 Get Directions Write a Review

NPPES record last updated: May 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Magnolia Diagnostic Services Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGNOLIA DIAGNOSTIC SERVICES INC. (NPI 1770375768) is a healthcare organization registered as a nurse practitioner in Shreveport, Louisiana and active in the NPI registry since May 2025. The organization lists Dewarrent Lee Brantley, Ceo/owner, as its authorized official.

NPPES Registry Identity

NPI1770375768
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameMAGNOLIA DIAGNOSTIC SERVICES INC.
Location Address4005 LAKESHORE DRShreveport, LA 71109-1927
Mailing Address4005 Lakeshore DrShreveport, LA 71109-1927 · (318) 840-9074
Phone(318) 840-9074
Organization SubpartNo
Authorized OfficialDewarrent Lee BrantleyCeo/owner · (318) 840-9074
Enumeration DateMay 19, 2025
Last NPPES UpdateMay 22, 2025
NPPES CertifiedMay 22, 2025
✔ NPI 1770375768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
4005 LAKESHORE DR, Shreveport, LA 71109
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAGNOLIA REHABILITATION SERVICES INC
Clinic/Center (Multi-Specialty)
4005 LAKESHORE DR
SHREVEPORT, LA 71109
Caddo Parish (337) 324-8465

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magnolia Diagnostic Services Inc.'s NPI number?

The NPI number for Magnolia Diagnostic Services Inc. is 1770375768. It was assigned to this organization in the NPPES registry on May 19, 2025.

Where is Magnolia Diagnostic Services Inc. located?

Magnolia Diagnostic Services Inc. is located at 4005 Lakeshore Dr, Shreveport, LA 71109. The listed phone number is (318) 840-9074.

What is Magnolia Diagnostic Services Inc.'s specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Magnolia Diagnostic Services Inc. was last updated on May 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.