MEDICARE: PAISLEY FAMILY MEDICAL CENTER, 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	363LF0000X	Family Nurse Practitioner	AP04742	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184089492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAISLEY FAMILY MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	4910 HOWARD AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-1116
Country	:	US
Telephone Number	:	504-390-0539
Fax Number	:	504-322-2622

Provider Business Practice Location Address
First Line	:	4301 ELYSIAN FIELDS AVE STE 103
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70122-7403
Country	:	US
Telephone Number	:	504-962-9705
Fax Number	:	504-962-9707

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	MONIQUE DANNETTE BARCONEY
Credential	:	DNP,MPH,APRN,FNP-C
Telephone Number	:	504-962-9705

Provider Enumeration Date	:	12/31/2015
Last Update Date	:	03/29/2024

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