Individual
PAULA S LICCIARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
410 W JUDGE PEREZ DR, CHALMETTE, LA 70043-4906
(504) 249-5187
(504) 304-9951
Mailing address
410 W JUDGE PEREZ DR, CHALMETTE, LA 70043-4906
(504) 669-6638
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN073519
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19D1083407
CLIA CERTIFICATE OF WAVIER
LA
Enumeration date
09/24/2007
Last updated
04/18/2018
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