Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Magnolia Diagnostic Services Inc

Organization Nurse Practitioner · NPI 1770375768

Magnolia Diagnostic Services Inc is a Nurse Practitioner in Shreveport, Louisiana. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4005 Lakeshore Dr
Shreveport, LA 71109-1927
Phone: (318) 840-9074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1770375768
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dewarrent Brantley — Ceo/Owner · (318) 840-9074
NPI enumeratedMay 19, 2025
Last updated in NPPESMay 22, 2025
Certification dateMay 22, 2025
Mailing address4005 Lakeshore Dr, Shreveport, LA 71109-1927

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