1992947675 NPI number — MRS. RACHEL TILL LOBELL FNP

Table of content: MRS. RACHEL TILL LOBELL FNP (NPI 1992947675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992947675 NPI number — MRS. RACHEL TILL LOBELL FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOBELL
Provider First Name:
RACHEL
Provider Middle Name:
TILL
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:
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:
1992947675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4200 HOUMA BLVD 3RD FLOOR
Provider Second Line Business Mailing Address:
EJPM
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70006-2970
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-503-5205
Provider Business Mailing Address Fax Number:
504-503-6019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1847 DOCK ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HARAHAN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70123-1600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-733-1100
Provider Business Practice Location Address Fax Number:
504-733-1184
Provider Enumeration Date:
03/27/2009

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:  AP05571 , 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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