Fegley, Brinton J

Fegley, Brinton J is an individual health care provider with primary practice located at 2727 Hearne Ave , Shreveport LA 71103-3931. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Fegley, Brinton J can be contacted via phone (318) 631-6400.

Contact Information

Primary practice address
2727 Hearne Ave Shreveport LA 71103-3931
Phone: (318) 631-6400
Fax: (318) 631-0300
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP04104 Louisiana

Profile Details

NPI number 1790759462
LBN Legal business name Fegley, Brinton J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Jun 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790759462 NPPES
Louisiana MEDICAID 1160016

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