Individual
EBONI PAYTON ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN APRN FNP-C
Contact information
Practice address
1101 MEDICAL CENTER BLVD, MARRERO, LA 70072-3147
(504) 347-5511
Mailing address
2612 ANCHOR DR, MARRERO, LA 70072-6081
(504) 292-5057
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
212096
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2521799
—
LA
Enumeration date
04/16/2020
Last updated
08/19/2022
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