Marissa Adams
Physician Assistant in Shreveport, LA. Individual provider (NPI-1).
NPI number1972900033
StatusActive
Last updated in NPPESAug 20, 2024
Details
- NPI
- 1972900033
- Entity type
- Individual (NPI-1)
- Name
- Marissa Adams
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 4, 2014
- Certification date
- Aug 20, 2024
- Last updated
- Aug 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 200750 | LA | Yes |
Practice location
1811 E Bert Koun LoopSuite 110
Shreveport, LA 71105-5740
Phone 318-212-3858 · Fax 318-212-3958
Mailing address
1811 E Bert Koun LoopSuite 110
Shreveport, LA 71105-5740
Phone 318-212-3858 · Fax 318-212-3958
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