=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225753957
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXA SHEA PARRIA FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2022
-----------------------------------------------------
Last Update Date | 10/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3908 VETERANS MEMORIAL BLVD STE B
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70002-5642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-399-6556
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3418 MARIE CT
-----------------------------------------------------
City | LAFITTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70067-5322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-239-0329
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 224249
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------