IndividualActive
Krystal Ukaegbu, RN, MSN
NPI 1710787197 · Mental Illness Community Based Residential Treatment Facility · Shreveport, LA
Provider details
- NPI number
- 1710787197
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Credential
- RN, MSN
- Sex
- Female
- Sole proprietor
- Yes
- License
- RN131251 (LA)
Specialties & taxonomies
Residential Treatment Facilities
Nursing Service Providers
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility320900000X
Residential Treatment Facilities
Practice location
7000 Fern Ave Apt 135
Shreveport, LA 71105-4914
Phone: (318) 658-8303
Approximate (ZIP-level) locationGet directions
Mailing address
8880 Bernay Dr
Shreveport, LA 71118-2024
Registry dates
- Enumerated
- 2025-03-15
- Last updated
- 2025-07-09
- Certified
- 2025-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.