Individual
GHENET GHEBRETATIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4950 ESSEN LN STE 500, BATON ROUGE, LA 70809-3738
(225) 767-1311
(225) 766-0218
Mailing address
4950 ESSEN LN STE 500, BATON ROUGE, LA 70809-3738
(225) 767-1311
(225) 767-1335
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
091641-03998
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1120812
—
LA
Enumeration date
08/25/2008
Last updated
01/08/2021
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