Healthcare Provider Details

I. General information

NPI: 1033885207
Provider Name (Legal Business Name): ELAINE ISABELLE HANDCOCK DNP,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 GRAVIER ST
NEW ORLEANS LA
70112-2262
US

IV. Provider business mailing address

1900 GRAVIER ST
NEW ORLEANS LA
70112-2262
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-4221
  • Fax:
Mailing address:
  • Phone: 504-568-4221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number226963
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number226963
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number93323
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: