MEDICARE: THE CLINIC NOLA

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

General Provider Information

NPI Number	:	1770430662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CLINIC NOLA

Provider Business Mailing Address
First Line	:	1534 ALINE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-3512
Country	:	US
Telephone Number	:	504-399-0364
Fax Number	:

Provider Business Practice Location Address
First Line	:	1534 ALINE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-3512
Country	:	US
Telephone Number	:	504-399-0364
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KELLY BAQUET
Credential	:	APRN
Telephone Number	:	504-399-0364

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “THE CLINIC NOLA ” Practice Location

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