MEDICARE: MS. COLLEEN FRANTZ BODET MN, RN, FNP

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	RN056352 AP04063	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

General Provider Information

NPI Number	:	1447258744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. COLLEEN FRANTZ BODET MN, RN, FNP

Provider Business Mailing Address
First Line	:	1921 PENISTON ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-5355
Country	:	US
Telephone Number	:	504-897-1614
Fax Number	:	504-309-8115

Provider Business Practice Location Address
First Line	:	5625 LOYOLA AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-5014
Country	:	US
Telephone Number	:	504-359-1131
Fax Number	:	504-861-1780

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	11/17/2008

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