| Kenneth Lance Davenport, APRN | |
|
401 11th St Ne, Springhill, LA 71075-4503 | |
| (318) 539-1701 | |
| (318) 539-5688 |
| Full Name | Kenneth Lance Davenport |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 8 Years |
| Location | 401 11th St Ne, Springhill, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912483132 | NPI | - | NPPES |
| 2477765 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | AP10132 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Professional Hh Svc Of Minden | Minden, LA | Home health agency |
| Claiborne Memorial Medical Center | Homer, LA | Hospital |
| Springhill Medical Center | Springhill, LA | Hospital |
| Minden Medical Center | Minden, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Homer Memorial Hospital | 1456322692 | 19 |
| Entity Name | Springhill Medical Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124092481 PECOS PAC ID: 6002728912 Enrollment ID: O20040224000371 |
| Entity Name | Homer Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609066646 PECOS PAC ID: 1456322692 Enrollment ID: O20040803000291 |
| Entity Name | Webster Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245209527 PECOS PAC ID: 2961448170 Enrollment ID: O20050628000996 |
| Entity Name | Kisatchie Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235693847 PECOS PAC ID: 9537400270 Enrollment ID: O20190408001290 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Lance Davenport, APRN 401 11th St Ne, Springhill, LA 71075-4503 Ph: (318) 539-1701 | Kenneth Lance Davenport, APRN 401 11th St Ne, Springhill, LA 71075-4503 Ph: (318) 539-1701 |
Sonya Renee Thomas, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 11th St Ne, Springhill, LA 71075 Phone: 318-539-1701 Fax: 318-539-1725 | |
Ms. April J Scott, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 11th St Ne, Springhill, LA 71075 Phone: 318-539-1701 Fax: 318-539-5688 | |
Wilma Lynette Maynor, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 11th St Ne, Springhill, LA 71075 Phone: 318-539-1700 Fax: 318-539-5688 | |
Tommie Ann Cassidy, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 401 11th St Ne, Springhill, LA 71075 Phone: 318-539-7101 Fax: 318-539-1731 |