OrganizationChristus Health Northern Louisiana(<Unavail>)Nurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800(318) 681-4500PECOS EnrollmentBased on the most recent information from CMS, provider Christus Health Northern Louisiana does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1801822762Provider TypeOrganizationFull NameChristus Health Northern LouisianaOther Name<Unavail>SubpartNoEnumeration Date6/23/2006Last Updated10/7/2021Contact InformationPractice LocationPractice Address1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800Phone(318) 681-4500Fax(318) 681-4177Mailing LocationMailing Address1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800Phone(318) 681-4500Fax(318) 681-4177Authorized OfficialNameTrawick, Thomas Steen (Ceo)Phone(318) 681-5054Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense193LouisianaProvider IdentifiersIDDescriptionIssuerID1945897DescriptionMedicaidIssuerUnlistedLouisianaIDH3938DescriptionOtherIssuerBCBSLouisiana