Healthcare Provider Details

I. General information

NPI: 1831847433
Provider Name (Legal Business Name): JOSHUA ALEXANDER HELLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2022
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 COPPER MILL BLVD
ZACHARY LA
70791-7393
US

IV. Provider business mailing address

1100 FLORIDA AVE # 220
NEW ORLEANS LA
70119-2715
US

V. Phone/Fax

Practice location:
  • Phone: 225-286-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7364
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: