Krista Phillips Connell
Individual provider Active NPI Nurse Practitioner · Jackson, LA
NPI 1881733673 · NPPES record last updated May 22, 2012
Key facts
- NPI
- 1881733673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP05081 (LA)
- Practice address
- 3501 Highway 10
Jackson, LA 70748-6238 - Phone
- (225) 683-5292
- Fax
- (225) 683-3411
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP05081 | LA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP05081 | LA | Yes |
Addresses
Primary practice location
3501 Highway 10
Jackson, LA 70748-6238
Mailing address
PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1409723 | Medicaid | LA |
Other providers in Jackson, LA
- Kelsey Tomb Carter
- Cataldie Publishing LLC
- Allison B Coleman
- Hugh A Coleman
- Rhonda B Coleman
- Pauline Sue Cooper-North
- Meagan Curtis
- Gregory J Dolese
- Tyrie Dunn
- East Louisiana State Hospital
All providers in Jackson, LA · Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.