Healthcare Provider Details

I. General information

NPI: 1851178354
Provider Name (Legal Business Name): LEILA BRACHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6311 MAGAZINE ST
NEW ORLEANS LA
70118-5828
US

IV. Provider business mailing address

6311 MAGAZINE ST
NEW ORLEANS LA
70118-5828
US

V. Phone/Fax

Practice location:
  • Phone: 720-377-7411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number247622
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number1669051
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: