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

Gina Yi Inthavong, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1912579301

Gina Yi Inthavong, NURSEPRACTITIONER is a Nurse Practitioner in Shreveport, Louisiana. Qualified in 2021, 5 years ago. Practices with Northwest Louisiana Nephrology, LLC, a 23-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
5
Licensed in
LA
In the registry since
2021
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Practice location Address checks out

1800 Buckner St Ste C120
Shreveport, LA 71101-4453
Phone: (318) 227-8899
Fax: (318) 425-3793
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2501 Greenwood Rd, Shreveport, LA 71103-3905 — (318) 631-1584

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 221149 (LA)

Record details

NPI number1912579301
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedJuly 14, 2021
Last updated in NPPESJuly 14, 2021
Certification dateJuly 14, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northwest Louisiana Nephrology, Llc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Shreveport