Healthcare Provider Details

I. General information

NPI: 1508539941
Provider Name (Legal Business Name): GABRIELLE LETORT DNP, APRN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HENRY CLAY AVE
NEW ORLEANS LA
70118-5798
US

IV. Provider business mailing address

3017 KENT AVE
METAIRIE LA
70006-5106
US

V. Phone/Fax

Practice location:
  • Phone: 504-896-9418
  • Fax:
Mailing address:
  • Phone: 504-342-8127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number221200
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: