1144584087 NPI number — MRS. ANGELA CERDA HAMBY APRN

Table of content: MRS. ANGELA CERDA HAMBY APRN (NPI 1144584087)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144584087 NPI number — MRS. ANGELA CERDA HAMBY APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMBY
Provider First Name:
ANGELA
Provider Middle Name:
CERDA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1144584087
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5000 FORSYTHE BYP
Provider Second Line Business Mailing Address:
STE 118
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71201-2168
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-737-1381
Provider Business Mailing Address Fax Number:
318-737-1349

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5000 FORSYTHE BYPASS
Provider Second Line Business Practice Location Address:
SUITE 118
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71201-2168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-737-1381
Provider Business Practice Location Address Fax Number:
318-737-1349
Provider Enumeration Date:
06/26/2012

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: 363L00000X , with the licence number:  AP06896 , 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)





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