MEDICARE: HEATHER POMFRET CHICO NP

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
1	363LF0000X	Family Nurse Practitioner	225114	LA

General Provider Information

NPI Number	:	1669101879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER POMFRET CHICO NP

Provider Business Mailing Address
First Line	:	1514 JEFFERSON HWY
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70121-2429
Country	:	US
Telephone Number	:	504-842-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 ALLEN TOUSSAINT BLVD STE C
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-2588
Country	:	US
Telephone Number	:	504-831-3112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	12/20/2023

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