Individual
STEPHANIE LOUISE GRAVOIS-RUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1440 CANAL ST, NEW ORLEANS, LA 70112-2703
(504) 988-7829
Mailing address
905 OLD METAIRIE PL, METAIRIE, LA 70001-6085
(504) 234-8513
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
026085
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026085
STATE LICENSE NUMBER
LA
05
—
1055131
—
LA
01
—
31366
STATE CDS NUMBER
LA
Enumeration date
04/26/2007
Last updated
03/07/2023
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