Healthcare Provider Details
I. General information
NPI: 1306776109
Provider Name (Legal Business Name): AMALACHI EWENI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 OCHSNER BLVD STE 160
GRETNA LA
70056-5278
US
IV. Provider business mailing address
120 OCHSNER BLVD STE 160
GRETNA LA
70056-5278
US
V. Phone/Fax
- Phone: 504-842-8119
- Fax:
- Phone: 504-842-8119
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 237614 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: