Healthcare Provider Details

I. General information

NPI: 1366705634
Provider Name (Legal Business Name): SCOTT JOSEPH ST.AMANT APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 05/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARINERS PLAZA DR SUITE 504
MANDEVILLE LA
70448-6821
US

IV. Provider business mailing address

500 MARINERS PLAZA DR SUITE 504
MANDEVILLE LA
70448-6821
US

V. Phone/Fax

Practice location:
  • Phone: 985-246-1250
  • Fax: 985-246-1251
Mailing address:
  • Phone: 985-246-1250
  • Fax: 985-246-1251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPO6828
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberLA89100
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: