MEDICARE: ROBERT VARNADO PSYCHIATRIC SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP07704	LA

General Provider Information

NPI Number	:	1023217403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT VARNADO PSYCHIATRIC SERVICES, LLC

Provider Business Mailing Address
First Line	:	4480 GENERAL DEGAULLE DR
Second Line	:	SUITE 107
City	:	NEW ORLEANS
State	:	LA
Zip	:	70131-6941
Country	:	US
Telephone Number	:	504-393-6355
Fax Number	:	504-393-6388

Provider Business Practice Location Address
First Line	:	4480 GENERAL DEGAULLE DR
Second Line	:	SUITE 107
City	:	NEW ORLEANS
State	:	LA
Zip	:	70131-6941
Country	:	US
Telephone Number	:	504-393-6355
Fax Number	:	504-393-6388

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MELANIE BAKER VARNADO
Credential	:	DNP, APRN
Telephone Number	:	504-393-6355

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	09/15/2016

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