Provider Demographics
NPI:1033264809
Name:GROENE, BEATRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:
Last Name:GROENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15785 MEDICAL ARTS DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1447
Mailing Address - Country:US
Mailing Address - Phone:985-543-4080
Mailing Address - Fax:
Practice Address - Street 1:15785 MEDICAL ARTS DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1447
Practice Address - Country:US
Practice Address - Phone:985-543-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA163332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0090212Medicaid
LA53778Medicare ID - Type Unspecified
LA0090212Medicaid