Magnolia Diagnostic Services Inc.
NPI 1770375768ActiveOrganization· Nurse Practitioner· Shreveport, LA
Nurse Practitioner in Shreveport, Louisiana, registered in NPPES in May 2025. The authorized official on file is Dewarrent Lee Brantley, Ceo/Owner.
Overview
| NPI | 1770375768 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 19, 2025 |
| Last updated in NPPES | May 22, 2025 |
| Certified by provider | May 22, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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