Individual
ELIZABETH DIMITRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1545 TULANE AVE, NEW ORLEANS, LA 70112-2821
(504) 903-1301
Mailing address
3813 METAIRIE HEIGHTS AVE, METAIRIE, LA 70002-1826
(877) 271-4597
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN090596
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14366241
—
LA
01
—
RN090596
STATE LICENSE NUMBER
LA
Enumeration date
05/03/2007
Last updated
07/09/2007
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