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General NPI Number Information
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NPI Number | 1447161278
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Entity Type | Individual
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Provider Name | AMIA ANTHONY
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Gender | Female
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Dates
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Enumeration Date | 09/12/2026
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Last Update Date | 09/12/2026
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Provider Practice Location Address
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Address Line | 1214 COOLIDGE BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2621
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Country | US
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Telephone | 337-289-7991
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Fax |
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Provider Business Mailing Address
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Address Line | 630 BROTHERS RD TRLR 60
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City | LAFAYETTE
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State | LA
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Zip | 70507-5226
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Country | US
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Telephone | 337-962-1811
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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 | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 234742
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 30001796
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 234742
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License Number State | LA
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