Individual
TARA J. REDWANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP06222
LA
363LF0000X
Family Nurse Practitioner
Primary
AP06222
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02536748
—
MS
05
—
2126377
—
LA
Enumeration date
09/15/2010
Last updated
02/08/2023
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