Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP08231 | LA |
NPI | 1033505912 |
---|---|
Provider Name | Mrs. Erin Gena Monachello |
First Address | Baton Rouge, LA 70810-6381 |
Second Address | Lafayette, LA 70508-5173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 03/03/2020 |