Healthcare Provider Details

I. General information

NPI: 1285315929
Provider Name (Legal Business Name): TIANDRA VERSHAWN SINGLETON WATTERS APRN-WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIANDRA VERSHAWN SINGLETON

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 NAPOLEON AVE
NEW ORLEANS LA
70115-6969
US

IV. Provider business mailing address

4241 SKIPJACK CV
NICEVILLE FL
32578-7150
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-4000
  • Fax:
Mailing address:
  • Phone: 931-249-7654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number229720
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: