Provider Demographics
NPI:1235177411
Name:ANGELETTE, ELIZABETH A (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:ANGELETTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:GISCLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:144 W 134TH ST
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-4155
Mailing Address - Country:US
Mailing Address - Phone:985-632-6233
Mailing Address - Fax:985-632-7526
Practice Address - Street 1:144 W 134TH ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-4155
Practice Address - Country:US
Practice Address - Phone:985-632-6233
Practice Address - Fax:985-632-7526
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO4662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1621889Medicaid
LA1621889Medicaid