Healthcare Provider Details

I. General information

NPI: 1417869249
Provider Name (Legal Business Name): ALYSSIA JANAE EWING PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 JEFFERSON HWY STE A
NEW ORLEANS LA
70121-2448
US

IV. Provider business mailing address

1405 JEFFERSON HWY STE A
NEW ORLEANS LA
70121-2448
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-7439
  • Fax: 504-842-6931
Mailing address:
  • Phone: 504-842-7439
  • Fax: 504-842-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.026388
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: