Healthcare Provider Details

I. General information

NPI: 1912621632
Provider Name (Legal Business Name): MARCIANO RAZIANO FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ESPLANADE AVE
KENNER LA
70065-2489
US

IV. Provider business mailing address

4401 S CLAIBORNE AVE
NEW ORLEANS LA
70125-5105
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-4910
  • Fax: 504-429-2578
Mailing address:
  • Phone: 504-891-7737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number227432
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: