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Individual

AMANDA HERRICK ESTAPA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
16065 LAMONTE DR, HAMMOND, LA 70403-1405
(985) 892-7070
(985) 892-7017
Mailing address
PO BOX 1089, HAMMOND, LA 70404-1089
(985) 892-7070

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP05167
LA
363L00000X
Nurse Practitioner
RN095442
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00687066
MS
05
1012131
LA
Enumeration date
05/29/2007
Last updated
05/22/2019
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