Healthcare Provider Details

I. General information

NPI: 1134498025
Provider Name (Legal Business Name): AUDUBON HEALTH SPECIALTY, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 AUDUBON BLVD
NEW ORLEANS LA
70125-4124
US

IV. Provider business mailing address

335 AUDUBON BLVD
NEW ORLEANS LA
70125-4124
US

V. Phone/Fax

Practice location:
  • Phone: 985-264-8037
  • Fax: 504-865-0371
Mailing address:
  • Phone: 985-264-8037
  • Fax: 504-865-0371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP06367
License Number StateLA

VIII. Authorized Official

Name: ELAINE LONGLEY ALLEMAN
Title or Position: OWNER
Credential: ANP-C
Phone: 985-264-8037