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General NPI Number Information
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NPI Number | 1356686786
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Entity Type | Individual
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Provider Name | AMANDA G GREGOIRE FNP
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Gender | Female
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 02/11/2013
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Provider Practice Location Address
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Address Line | 4429 CLARA ST STE 340
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City | NEW ORLEANS
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State | LA
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Zip | 70115-6902
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Country | US
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Telephone | 504-412-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 SAINT CHARLES AVE
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City | NEW ORLEANS
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State | LA
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Zip | 70115-4637
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Country | US
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Telephone | 504-412-1100
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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 | AP06895
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License Number State | LA
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