1538411103 NPI number — KELLY MEILLEUR-LABEAUD APRN, FNP

Table of content: KELLY MEILLEUR-LABEAUD APRN, FNP (NPI 1538411103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538411103 NPI number — KELLY MEILLEUR-LABEAUD APRN, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEILLEUR-LABEAUD
Provider First Name:
KELLY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEILLEUR
Provider Other First Name:
KELLY
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:
1538411103
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13038
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:
70185-3038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-207-3060
Provider Business Mailing Address Fax Number:
504-212-9548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5640 READ BLVD
Provider Second Line Business Practice Location Address:
SUITE 550
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70127-3140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-248-5357
Provider Business Practice Location Address Fax Number:
504-248-5377
Provider Enumeration Date:
10/08/2012

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: 163W00000X , with the licence number:  RN088734 , 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: AP07085 , 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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