MEDICARE: ANASTASIA LOPICCOLO CAMP ANP

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	363L00000X	Nurse Practitioner	AP08526	LA

General Provider Information

NPI Number	:	1407227531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIA LOPICCOLO CAMP ANP

Provider Business Mailing Address
First Line	:	8923 BLUEBONNET BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-2814
Country	:	US
Telephone Number	:	225-766-4133
Fax Number	:	225-766-4135

Provider Business Practice Location Address
First Line	:	8923 BLUEBONNET BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-2814
Country	:	US
Telephone Number	:	225-766-4133
Fax Number	:	225-766-4135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2015
Last Update Date	:	06/07/2022

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