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NPI Code Detail

MEDICARE: DR. AISHA IFETAYA PIERRE CRNA

MEDICARE: DR. AISHA IFETAYA PIERRE CRNA
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
1163W00000XRegistered NurseRN140553LA
2367500000XCertified Registered Nurse Anesthetist220364LA

General Provider Information

NPI Number : 1912574815
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AISHA IFETAYA PIERRE CRNA
Provider Business Mailing Address
First Line : 13985 TECH DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70818-2956
Country : US
Telephone Number : 225-252-8142
Fax Number :
Provider Business Practice Location Address
First Line : 1401 FOUCHER ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70115-3593
Country : US
Telephone Number : 504-897-7666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2021
Last Update Date : 06/08/2021

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