Healthcare Provider Details

I. General information

NPI: 1194729657
Provider Name (Legal Business Name): AMELIE ANNE HOLLIER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W SAINT MARY BLVD STE 416
LAFAYETTE LA
70506-4600
US

IV. Provider business mailing address

103 DARWIN CIR
LAFAYETTE LA
70508-7110
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-4746
  • Fax: 337-289-2226
Mailing address:
  • Phone: 337-289-4746
  • Fax: 337-289-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: