Provider Demographics
NPI:1073850871
Name:GOLDVARG-ABUD, INNA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:INNA
Middle Name:
Last Name:GOLDVARG-ABUD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:INNA
Other - Middle Name:
Other - Last Name:GOLDVARG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1430 TULANE AVE # 8545
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:909-558-3636
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE # 8545
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:909-558-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07051363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily