Provider Demographics
NPI:1346636669
Name:NACCARI, BRANDI DUCOTE (MD)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:DUCOTE
Last Name:NACCARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:RENEE DAUTREUIL
Other - Last Name:DUCOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3100 KINGMAN ST STE 110
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5419
Mailing Address - Country:US
Mailing Address - Phone:504-887-6355
Mailing Address - Fax:504-888-3747
Practice Address - Street 1:3100 KINGMAN ST STE 110
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006
Practice Address - Country:US
Practice Address - Phone:504-887-6355
Practice Address - Fax:504-888-3747
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA308370208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2389581Medicaid