1609323476 NPI number — MRS. SARAH LIRETTE SOILEAU FNP

Table of content: MRS. SARAH LIRETTE SOILEAU FNP (NPI 1609323476)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609323476 NPI number — MRS. SARAH LIRETTE SOILEAU FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOILEAU
Provider First Name:
SARAH
Provider Middle Name:
LIRETTE
Provider Name Prefix Text:
MRS.
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:
LIRETTE
Provider Other First Name:
SARAH
Provider Other Middle Name:
ELIZABETH
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:
1609323476
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 WAINWRIGHT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARAHAN
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70123-4413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-666-0193
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4429 CLARA ST
Provider Second Line Business Practice Location Address:
MCFARLAND MEDICAL PLAZA SUITE 600
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70115-6902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-894-2672
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2016

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:  AP08800 , 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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