Healthcare Provider Details

I. General information

NPI: 1417665613
Provider Name (Legal Business Name): GERIATRIC PROFESSIONAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 PARK AVE
MANDEVILLE LA
70448-4915
US

IV. Provider business mailing address

PO BOX 111
COVINGTON LA
70434-0111
US

V. Phone/Fax

Practice location:
  • Phone: 985-256-5599
  • Fax: 988-256-5687
Mailing address:
  • Phone: 985-200-4726
  • Fax: 985-338-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANDRA ALMERICO
Title or Position: NP/OWNER
Credential: NP
Phone: 985-200-4726