Individual
MRS. AMANDA CENAC MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE S350, MARRERO, LA 70072-3151
(504) 349-6350
(504) 934-8701
Mailing address
1111 MEDICAL CENTER BLVD, SUITE S350, MARRERO, LA 70072-3151
(504) 349-6350
(504) 934-8701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200632
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00287527
—
MS
05
—
2370316
—
LA
Enumeration date
07/03/2013
Last updated
09/19/2019
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