Healthcare Provider Details

I. General information

NPI: 1164349106
Provider Name (Legal Business Name): ANDREA NICOLE GREENHPOUSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W MORRIS AVE
HAMMOND LA
70403-3854
US

IV. Provider business mailing address

1204 N OAK ST
HAMMOND LA
70401-1840
US

V. Phone/Fax

Practice location:
  • Phone: 985-662-3799
  • Fax:
Mailing address:
  • Phone: 985-662-3799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: