Healthcare Provider Details

I. General information

NPI: 1083631758
Provider Name (Legal Business Name): ROBERT A VARNADO IINC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 GENERAL DEGAULLE DR SUITE 4030
NEW ORLEANS LA
70114-6757
US

IV. Provider business mailing address

5240 STONEWALL DR
BATON ROUGE LA
70817-2549
US

V. Phone/Fax

Practice location:
  • Phone: 504-363-7448
  • Fax: 504-363-7421
Mailing address:
  • Phone: 225-756-1325
  • Fax: 225-756-1325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN038204 AP04652
License Number StateLA

VIII. Authorized Official

Name: MR. ROBERT ALLEN VARNADO
Title or Position: PRESIDENT
Credential: NP
Phone: 225-892-3308