Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | 46059 | TN |
Y | 2080P0202X | Pediatric Cardiologist | MD.202857 | LA |
NPI | 1144370941 |
---|---|
Provider Name | Jessica Hebert Mouledoux |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 17/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00421047 | (05) | MS |
1889407 | (05) | LA |