Individual
MRS. MALLORY LASSALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5798
(504) 896-9418
Mailing address
833 ROSA AVE, METAIRIE, LA 70005-2127
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
221800
LA
Other
Enumeration date
08/24/2021
Last updated
12/15/2021
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