Healthcare Provider Details

I. General information

NPI: 1952580839
Provider Name (Legal Business Name): JANICE BIRKHOFF FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 01/29/2024
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 BRIANT ST
GRETNA LA
70056-7136
US

IV. Provider business mailing address

2104 GAUSE BLVD W STE. A
SLIDELL LA
70460-4130
US

V. Phone/Fax

Practice location:
  • Phone: 985-643-4575
  • Fax: 833-222-4520
Mailing address:
  • Phone: 985-643-4575
  • Fax: 833-222-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPO5076
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: