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General NPI Number Information
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NPI Number | 1407322878
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Entity Type | Individual
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Provider Name | MARIA ANGELICA NAZAR PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 4315 HOUMA BLVD STE 500
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City | METAIRIE
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State | LA
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Zip | 70006-2942
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Country | US
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Telephone | 504-889-5250
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Fax | 504-889-5248
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Provider Business Mailing Address
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Address Line | 4204 SAINT ANN DR
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City | KENNER
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State | LA
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Zip | 70065-1651
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Country | US
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Telephone | 504-338-7748
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 312952
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License Number State | LA
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