Healthcare Provider Details

I. General information

NPI: 1356637649
Provider Name (Legal Business Name): KIANA A TREGRE MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 STATE ST BLDG 10
NEW ORLEANS LA
70118-5735
US

IV. Provider business mailing address

200 HENRY CLAY AVE
NEW ORLEANS LA
70118-5798
US

V. Phone/Fax

Practice location:
  • Phone: 504-896-7200
  • Fax:
Mailing address:
  • Phone: 504-899-9511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD32433
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD37287
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number302161
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: