Individual provider Active NPI

Holly Daquana, NP

  • Family Nurse Practitioner
  • Houma, LA
National Provider Identifier
1063458966
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP04301 Issued in LA
Practice address
1990 Industrial Boulevard
Houma, LA 70363-7055
Phone
(985) 868-9300
Fax
(985) 851-0053
NPI assigned
Jun 21, 2006
Last updated
Feb 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP04301 LA Primary

Addresses

Primary practice location

1990 Industrial Boulevard
Houma, LA 70363-7055

Mailing address

1990 Industrial Boulevard
Houma, LA 70363-7055
Phone (985) 868-9300

Other identifiers 1

IdentifierTypeStateIssuer
1169897MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031124000241 LA Practitioner - Nurse Practitioner 0244134062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1990 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 868-9300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP04301LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Louisiana Medical Associates CurrentSince Nov 1, 2003 Accepting new patients
South Louisiana Medical Associates Nurse Practitioner CurrentSince Nov 1, 2003 Accepting new patients
South Louisiana Medical Associates Family Current Accepting new patients

Locations

1990 Industrial Blvd
Houma, LA 70363
Phone (985) 868-9300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1063458966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BOULEVARD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BOULEVARD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAQUANA",
        "first_name": "HOLLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP04301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1169897",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.