Wandria Coleman Dallas, APRN

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

AP10195 Issued in LA

Practice address

1541 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 626-1855

Fax

(318) 698-8182

NPI assigned

Jan 19, 2019

Last updated

Jan 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Interoperability endpoints

• Direct secure messaging: wdallas863208@direct.ochsner.org

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

{
    "created_epoch": "1547856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547856000000",
    "number": "1902370273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 ELMER LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711091934",
            "telephone_number": "318-560-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-1855",
            "fax_number": "318-698-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "WANDRIA",
        "middle_name": "COLEMAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-19",
        "last_updated": "2019-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "LA",
            "license": "AP10195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gaylon Daigle, M.D.
• Drake Wimberly Daily, D.O
• Mallory Elizabeth Daily, CSW, MSW
• Dale P McGinty, MD and Willis-Knighton Medical Center
• Theodore Dallas
• Reese Addison Dalton
• Damita Braswell
• Abdul Damra
• Dana George NP and Willis-Knighton Medical Center
• Shilpa Raman Danagara

• Gerontology Clinical Nurse Specialist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Gerontology Clinical Nurse Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.