Provider Demographics
NPI:1033914858
Name:COOMANS, AMANDA PRYSILLA ELISABETH (AGACNP-BC, FNP-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:PRYSILLA ELISABETH
Last Name:COOMANS
Suffix:
Gender:F
Credentials:AGACNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 HOUMA BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2996
Mailing Address - Country:US
Mailing Address - Phone:504-503-4000
Mailing Address - Fax:
Practice Address - Street 1:4320 HOUMA BLVD STE 700
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2673
Practice Address - Country:US
Practice Address - Phone:504-503-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA227788363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner