Provider Demographics
NPI:1023565512
Name:ARMSTRONG, GRACIE MARLO
Entity Type:Individual
Prefix:MRS
First Name:GRACIE
Middle Name:MARLO
Last Name:ARMSTRONG
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 1:5640 READ BLVD STE 740
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3131
Mailing Address - Country:US
Mailing Address - Phone:504-245-2440
Mailing Address - Fax:
Practice Address - Street 1:5640 READ BLVD STE 740
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127
Practice Address - Country:US
Practice Address - Phone:504-245-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator