Individual provider · Type 1 NPI

Kerri Lucken Tynes, P.A.

Medical Physician Assistant · Bossier City, LA

NPI number 1104004720 Active

Practice location

2300 Hospital Dr, Suite 450
Bossier City, LA 71111-2394

Call (318) 752-2328 Map

Fax (318) 746-0160

Mailing address

2727 Hearne Ave, Suite 301
Shreveport, LA 71103-3931

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XA10314 (LA)

Medical Physician Assistant: Definition to come...

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About NPI 1104004720

Kerri Lucken Tynes, P.A.'s National Provider Identifier is 1104004720, issued on Feb 6, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Bossier City, LA. The record was last updated on Feb 6, 2008.