1306021092 NPI number — PROF. SCHARALDA GETZ JEANFREAU FNP

Table of content: PROF. SCHARALDA GETZ JEANFREAU FNP (NPI 1306021092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306021092 NPI number — PROF. SCHARALDA GETZ JEANFREAU FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JEANFREAU
Provider First Name:
SCHARALDA
Provider Middle Name:
GETZ
Provider Name Prefix Text:
PROF.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306021092
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1900 GRAVIER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70112-2262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-568-4140
Provider Business Mailing Address Fax Number:
504-568-5853

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3700 SAINT CHARLES AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70115-4637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-412-1100
Provider Business Practice Location Address Fax Number:
504-412-1593
Provider Enumeration Date:
01/01/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  01606 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1540439 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".