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NPI Code Detail

MEDICARE: DR. LISA H. NICOLETTI DNP, APRN, FNP-BC

MEDICARE: DR. LISA H. NICOLETTI DNP, APRN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerR869017MS
2363LF0000XFamily Nurse PractitionerRN073931-AP03946LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427050822
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA H. NICOLETTI DNP, APRN, FNP-BC
Provider Business Mailing Address
First Line : 2009 RUBICH LN
Second Line :
City : SLIDELL
State : LA
Zip : 70461-1362
Country : US
Telephone Number : 985-640-9422
Fax Number :
Provider Business Practice Location Address
First Line : 510 E STONER AVE # 5N19
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-4243
Country : US
Telephone Number : 318-221-8411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 09/14/2023

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