Basic Information
Provider Information
NPI: 1992474118
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CABECEIRAS
FirstName: MICHELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1514 JEFFERSON HWY
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701212429
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1514 JEFFERSON HWY
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701212429
CountryCode: US
TelephoneNumber: 5048424021
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/10/2021
LastUpdateDate: 03/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X222164LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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