HOLLY GAINES SCURLOCK (NPI# 1134469463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134469463 |
| Entity Type | Individual |
| Full Name | HOLLY GAINES SCURLOCK |
| Credential | PA-C |
| Practice Address |
9300 Mansfield Rd Shreveport LA 71118-3155 |
| Practice Telephone | 3186293763 |
| Practice Fax Number | 3186293767 |
| Mailing Telephone | 3186293763 |
| Mailing Fax Number | 3186293767 |
| Enumeration Date | 2013-02-23 |
| Last Update Date | 2013-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA.200600 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9300 MANSFIELD RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992831804 | Robert Scott Matthews | Dentist | 9300 Mansfield Rd, Suite 100, Shreveport, LA 71118-3155 | 2007-02-26 |
| 1144685470 | Ambulatory Strategies Physician Group of Louisiana LLC | Clinic/Center | 9300 Mansfield Rd, Suite 110, Shreveport, LA 71118-3155 | 2015-12-31 |
| 1245661487 | Claire Hammond | Physician Assistant | 9300 Mansfield Rd, Suite 110, Shreveport, LA 71118-3155 | 2013-12-12 |
| 1255680724 | Velocity Md LLC | Clinic/Center | 9300 Mansfield Rd, Suite 110, Shreveport, LA 71118-3137 | 2012-08-30 |
| 1720266505 | Janet Lyn Huff | Counselor | 9300 Mansfield Rd, Suite 107, Shreveport, LA 71118-3155 | 2008-02-04 |
| 1164611562 | Driggers Diabetic Supply LLC | Durable Medical Equipment & Medical Supplies | 9300 Mansfield Rd, # 105, Shreveport, LA 71118-2533 | 2007-10-22 |
| 1184838393 | Carmell Lenert-williams | Specialist | 9300 Mansfield Rd, Suite 110, Shreveport, LA 71118-3155 | 2007-05-09 |
| 1003033473 | New Horizons | Preferred Provider Organization | 9300 Mansfield Rd, Suite 204, Shreveport, LA 71118 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790228013 | Brian Keith Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2016-11-18 |
| 1831412626 | Christopher Micheal Magill | Physician Assistant | 2551 Greenwood Rd Ste 210, Shreveport, LA 71103-3985 | 2010-03-08 |
| 1851401426 | Teresa Bigler | Physician Assistant | 1606 Kings Hwy, Shreveport, LA 71103-4128 | 2006-08-30 |
| 1730118365 | Tina Faith Gentry | Physician Assistant | 7925 Youree Dr Suite 280b, Shreveport, LA 71105-5538 | 2006-07-03 |
| 1487616538 | David Stanley Staton | Physician Assistant | Overton Brooks Vamc, 510 East Stoner Ave, Shreveport, LA 71101 | 2006-04-04 |
| 1114924404 | Mary Mcferren | Physician Assistant | 1455 E Bert Kouns Industrial Loop # 200, Shreveport, LA 71105 | 2005-07-01 |
| 1487252029 | Melissa Raney | Physician Assistant | 2709 Mackey Ln, Shreveport, LA 71118-2556 | 2020-10-15 |
| 1629683230 | Amanda Renae Simmons | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1700496312 | Caroline Leigh Harris | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-07 |
| 1811459449 | Lyndsey Pate Day | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2019-04-02 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
Please comment or provide details below to improve the information on HOLLY GAINES SCURLOCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.