Provider Demographics
NPI:1811518772
Name:ERNEST, FELICIA
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:ERNEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6617 BENEDICT DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4612
Mailing Address - Country:US
Mailing Address - Phone:504-478-8928
Mailing Address - Fax:
Practice Address - Street 1:1702 STUMPF BLVD
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3923
Practice Address - Country:US
Practice Address - Phone:504-478-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health