Healthcare Provider Details

I. General information

NPI: 1033844808
Provider Name (Legal Business Name): AMANDA KRAUSE ROMANO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 07/18/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10319 JEFFERSON HWY
BATON ROUGE LA
70809-2730
US

IV. Provider business mailing address

8257 QUIET CREEK DR
DENHAM SPRINGS LA
70726-6619
US

V. Phone/Fax

Practice location:
  • Phone: 225-214-9352
  • Fax:
Mailing address:
  • Phone: 225-503-6673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226660
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: