DIVINITY HEALTHCARE CLINIC (NPI# 1326676792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326676792 |
| Entity Type | Organization |
| Organization Name | DIVINITY HEALTHCARE CLINIC |
| Practice Address |
4021 We Heck Ct Ste B1 Baton Rouge LA 70816-0405 |
| Mailing Address |
11515 Denham Rd Gonzales LA 70737-7787 |
| Practice Telephone | 2252567945 |
| Practice Fax Number | 2253518910 |
| Mailing Telephone | 2253012982 |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-05-05 |
| Authorized Official Name | MRS. DAWN MELANCON (FAMILY NURSE PRACTITIONER) |
| Authorized Official Telephone | 2253012982 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4021 WE HECK CT STE B1 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70816-0405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475128 | Exceptional Dental of Coursey, LLC | Dentist | 12045 Coursey Bvld., Baton Rouge, LA 70816 | 2020-10-26 |
| 1780294058 | Yolande Eileen Thomas | Case Manager/Care Coordinator | Array of Hope, 11940 Bricksome Ave, Baton Rouge, LA 70816 | 2020-08-03 |
| 1164052296 | Hoh Palliative Care, LLC | Family Medicine | 4212 American Way, Suite C, Baton Rouge, LA 70816 | 2020-01-16 |
| 1427698778 | Patricia Salton-hobson | Case Manager/Care Coordinator | 3888 S. Sherwood Forest Blvd Bldg II Ste F, Baton Rouge, LA 70816 | 2020-01-14 |
| 1467010447 | Niqueria Von'shea Mcswain | Licensed Practical Nurse | 2455 Weldwood Dr, Apt 6108, Baton Rouge, LA 70816 | 2019-06-04 |
| 1184184665 | Brent C Underwood | Chiropractor | 11851 Coursey Blvd., Baton Rouge, LA 70816 | 2019-03-21 |
| 1720544240 | Titus Randle II | Secured Medical Transport (VAN) | 1234 Pompey Dr, Baton Rouge, LA 70816 | 2019-02-20 |
| 1356820054 | Ashley Wheeler | Social Worker | 1761 Physicians Blvd., Baton Rouge, LA 70816 | 2018-08-13 |
| 1609355783 | Lynda W Thibodeaux | Counselor | 4021 W.e. Heck Court, Building B Suite 2, Baton Rouge, LA 70816 | 2018-08-09 |
| 1083193114 | Akamin Victor Nkengaka | Case Manager/Care Coordinator | Pelican Bayou Counseling Services, 3084 Westfolk Drive, Baton Rouge, LA 70816 | 2018-08-09 |
| Find all providers in zip 70816 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684923 | On -demand Healthcare of Louisiana LLC | Nurse Practitioner | 12109 Hampton Village Ave, Baton Rouge, LA 70818-5741 | 2020-09-22 |
| 1972116424 | Kiona Brooke Hayes | Nurse Practitioner | 1224 Meridian Dr, Baton Rouge, LA 70820-5316 | 2020-08-25 |
| 1932727286 | Alise Williams | Nurse Practitioner | 3333 Drusilla Ln Ste A, Baton Rouge, LA 70809-2418 | 2020-07-13 |
| 1881211803 | Shelita Banks | Nurse Practitioner | 11622 Flamingo Dr, Baton Rouge, LA 70814-7141 | 2020-06-26 |
| 1558985457 | Erika Halphen Forbes | Nurse Practitioner | 8281 Goodwood Blvd Ste D1, Baton Rouge, LA 70806-7742 | 2020-06-05 |
| 1477188738 | Kenisha Hampton Manuel | Nurse Practitioner | 4550 North Blvd Ste 100, Baton Rouge, LA 70806-4013 | 2020-03-06 |
| 1073157418 | Lakeva Marie Percy | Nurse Practitioner | 1522 Fig St, Baton Rouge, LA 70802-5028 | 2019-10-29 |
| 1144875162 | The Care Clinic LLC | Nurse Practitioner | 4336 North Blvd Ste 101, Baton Rouge, LA 70806-3920 | 2019-08-06 |
| 1467004127 | Eddricka Fleming Franklin | Nurse Practitioner | 5884 Benson Dr, Baton Rouge, LA 70812-2605 | 2019-07-12 |
| 1891255303 | Diana Boggs | Nurse Practitioner | 500 Rue De La Vie St Ste 400, Baton Rouge, LA 70817-5128 | 2019-03-21 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70816 |
Please comment or provide details below to improve the information on DIVINITY HEALTHCARE CLINIC.
| 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.