Individual
STACI M OLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 412-1860
Mailing address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 412-1860
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
09320R
LA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
09320R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09173210
—
MS
05
—
1965863
—
LA
Enumeration date
07/25/2006
Last updated
04/03/2013
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