Healthcare Provider Details

I. General information

NPI: 1558377036
Provider Name (Legal Business Name): BARBARA L KOWALESKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S MORRISON BLVD
HAMMOND LA
70403-5400
US

IV. Provider business mailing address

191 TCHEFUNCTE DR
COVINGTON LA
70433-4925
US

V. Phone/Fax

Practice location:
  • Phone: 985-340-7816
  • Fax:
Mailing address:
  • Phone: 985-893-4689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN045748AP02073
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: