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General NPI Number Information
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NPI Number | 1295683670
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Entity Type | Individual
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Provider Name | MAITTE CORONADO NP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 5000 HENNESSY BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70808-4375
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Country | US
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Telephone | 225-765-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 6432 TIGER POINTE DR
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City | BATON ROUGE
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State | LA
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Zip | 70817-5812
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Country | US
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Telephone | 985-703-2686
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 201382
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License Number State | LA
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