Provider Demographics
NPI:1295001477
Name:LINARELLO, RICKI LACOSTE (NP)
Entity Type:Individual
Prefix:
First Name:RICKI
Middle Name:LACOSTE
Last Name:LINARELLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RICKI
Other - Middle Name:LACOSTE
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 LOUIS PRIMA DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5903
Mailing Address - Country:US
Mailing Address - Phone:985-892-8934
Mailing Address - Fax:
Practice Address - Street 1:2120 DRIFTWOOD BLVD.
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065
Practice Address - Country:US
Practice Address - Phone:985-892-8934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-01
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06801363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2339168Medicaid
MS05675550Medicaid
LA261387YH3UMedicare PIN