Provider Demographics
NPI:1093064834
Name:TREADWAY-HAHN, ELSA ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:ELIZABETH
Last Name:TREADWAY-HAHN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 NELSON ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-6518
Mailing Address - Country:US
Mailing Address - Phone:504-669-8889
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE # 8031
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:504-988-5433
Practice Address - Fax:504-988-3508
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN103357363LF0000X
LAAP07014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2314980Medicaid
MS07173586Medicaid
LA2314980Medicaid