Active NPI
Eva Lois Ullom, RN, FNP-C
- Family Nurse Practitioner
- Deridder, LA
National Provider Identifier
1275829566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP06502
- Practice address
- 325 W 8TH St
Deridder, LA 70634-5505 - Phone
- (337) 463-3387
- Fax
- (949) 862-5301
- NPI assigned
- Jun 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP06502 | LA | Primary |
Addresses
Primary practice location
325 W 8TH St
Deridder, LA 70634-5505
Mailing address
2186 Ball Rd
Deridder, LA 70634-6656
Phone (337) 463-3766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308873600000",
"number": "1275829566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2186 BALL RD",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706346656",
"telephone_number": "337-463-3766",
"fax_number": "337-463-3766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 W 8TH ST",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706345505",
"telephone_number": "337-463-3387",
"fax_number": "949-862-5301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ULLOM",
"first_name": "EVA",
"middle_name": "LOIS",
"credential": "RN, FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-24",
"last_updated": "2011-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP06502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deridder, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.