MEDICARE: GWENDOLYN D FOXWORTH 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	APO1795	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	:	1902923220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWENDOLYN D FOXWORTH FNP

Provider Business Mailing Address
First Line	:	2269 MILTON ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70122-4540
Country	:	US
Telephone Number	:	504-909-7788
Fax Number	:	504-903-1975

Provider Business Practice Location Address
First Line	:	1400 POYDRAS ST.
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2821
Country	:	US
Telephone Number	:	504-903-1940
Fax Number	:

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

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	03/14/2013

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