Healthcare Provider Details

I. General information

NPI: 1376115592
Provider Name (Legal Business Name): ADRIENNA ERIN WINFREY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADRIENNA COLEMAN

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 SAINT CHARLES AVE APT 812
NEW ORLEANS LA
70130-8412
US

IV. Provider business mailing address

PO BOX 741632
NEW ORLEANS LA
70174-1632
US

V. Phone/Fax

Practice location:
  • Phone: 504-339-9330
  • Fax:
Mailing address:
  • Phone: 504-339-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: