1134414535 NPI number — MRS. PAULA SIDER BLAND FNP, PMHNP

Table of content: (NPI 1972125003)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134414535 NPI number — MRS. PAULA SIDER BLAND FNP, PMHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLAND
Provider First Name:
PAULA
Provider Middle Name:
SIDER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP, PMHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SIDER-BLAND
Provider Other First Name:
PAULA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134414535
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
609 METAIRIE RD
Provider Second Line Business Mailing Address:
PMB 4028
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-610-7459
Provider Business Mailing Address Fax Number:
651-409-5808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
609 METAIRIE RD
Provider Second Line Business Practice Location Address:
PMB 4028
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-610-7459
Provider Business Practice Location Address Fax Number:
651-409-5808
Provider Enumeration Date:
06/14/2011

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: 363LP0808X , with the licence number:  AP06616 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP06616 , 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: 122943 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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