Provider Demographics
NPI:1225259732
Name:O'LEARY, ANDREA KELLY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:KELLY
Last Name:O'LEARY
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 1:3924 ANNUNCIATION STREET
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-899-0189
Mailing Address - Fax:
Practice Address - Street 1:TULANE UNIVERSITY DEPARTMENT OF CHILD ADOL PSYCHIATRY
Practice Address - Street 2:1440 CANAL STREET TB52
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-0000
Practice Address - Country:US
Practice Address - Phone:504-988-7829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200767208000000X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1070556Medicaid
LA1070556Medicaid