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NPI Code Detail

MEDICARE: CRANEISHA NETTLES

MEDICARE: CRANEISHA NETTLES
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1528504388
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRANEISHA NETTLES
Provider Business Mailing Address
First Line : 300 N BROAD ST STE 106
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-5577
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 N BROAD ST STE 106
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-5577
Country : US
Telephone Number : 504-293-7900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2017
Last Update Date : 01/17/2017

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Directions to “ CRANEISHA NETTLES ” Practice Location

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