Mary Tillman Acosta, WHNP-BC
Nurse Practitioner, Women's Health in Shreveport, LA. Individual provider (NPI-1).
NPI number1356759153
StatusActive
Last updated in NPPESJul 6, 2021
Details
- NPI
- 1356759153
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Mary Tillman Acosta
- Credential
- WHNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 24, 2014
- Certification date
- Jul 6, 2021
- Last updated
- Jul 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LW0102X | Nurse Practitioner, Women's Health | AP07973 | LA | Yes |
Practice location
8001 Youree Dr Ste 300Shreveport, LA 71115-2303
Phone 318-212-3800 · Fax 318-212-3805
Mailing address
8001 Youree Dr Ste 320Shreveport, LA 71115-2354
Phone 318-212-2870 · Fax 318-212-2875
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