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General NPI Number Information
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NPI Number | 1174410971
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Entity Type | Organization
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Legal Business Name | NOLA 504 NP LLC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 2832 BURDETTE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70125-2514
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Country | US
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Telephone | 504-866-2741
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Fax |
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Provider Business Mailing Address
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Address Line | 601 MANSON AVE
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City | METAIRIE
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State | LA
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Zip | 70001-4826
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Country | US
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Telephone | 504-210-0890
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Fax | 855-452-4557
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRISTI S ANDREW
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Credential |
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Telephone | 504-210-0890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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