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NPI Code Detail

MEDICARE: MRS. ERIN GENA MONACHELLO NURSE PRACTITIONER

MEDICARE: MRS. ERIN GENA MONACHELLO NURSE PRACTITIONER
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
1363LP0200XPediatric Nurse PractitionerAP08231LA

General Provider Information

NPI Number : 1033505912
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ERIN GENA MONACHELLO NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 809 SUMMER BREEZE DR APT 1307
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-6381
Country : US
Telephone Number : 225-907-1686
Fax Number :
Provider Business Practice Location Address
First Line : 401 YOUNGSVILLE HWY STE 100
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-5173
Country : US
Telephone Number : 337-330-0031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2015
Last Update Date : 03/03/2020

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