Provider Demographics
NPI:1326350174
Name:GANT, KAREN MAXINE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MAXINE
Last Name:GANT
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 VALMONT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3024
Mailing Address - Country:US
Mailing Address - Phone:504-237-4975
Mailing Address - Fax:
Practice Address - Street 1:2411 WOOD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7932
Practice Address - Country:US
Practice Address - Phone:504-237-4976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65376-6146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily