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NPI Code Detail

MEDICARE: MARIE CHILDS SANDI FNP-BC

MEDICARE: MARIE CHILDS SANDI FNP-BC
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
1363LF0000XFamily Nurse PractitionerAPO5890LA

General Provider Information

NPI Number : 1518291632
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE CHILDS SANDI FNP-BC
Provider Business Mailing Address
First Line : 26851 HIGHWAY 23
Second Line :
City : PORT SULPHUR
State : LA
Zip : 70083-2509
Country : US
Telephone Number : 504-564-3344
Fax Number : 504-564-0174
Provider Business Practice Location Address
First Line : 26851 HIGHWAY 23
Second Line :
City : PORT SULPHUR
State : LA
Zip : 70083-2509
Country : US
Telephone Number : 504-564-3344
Fax Number : 504-564-0174
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2009
Last Update Date : 03/24/2010

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Directions to “ MARIE CHILDS SANDI FNP-BC” Practice Location

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