MEDICARE: MRS. ANGELA BRADLEY BYERS 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	RN071342-AP06321	LA

General Provider Information

NPI Number	:	1619279353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA BRADLEY BYERS FNP

Provider Business Mailing Address
First Line	:	10001 LAKE FOREST BLVD
Second Line	:	SUITE 201
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-6200
Country	:	US
Telephone Number	:	504-208-8467
Fax Number	:	504-244-9168

Provider Business Practice Location Address
First Line	:	10001 LAKE FOREST BLVD
Second Line	:	SUITE 201
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-6200
Country	:	US
Telephone Number	:	504-208-8467
Fax Number	:	504-244-9168

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

Provider Enumeration Date	:	12/01/2010
Last Update Date	:	11/30/2016

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