Provider Demographics
NPI:1407610900
Name:RODRIGUE, CORYN MONTALTO (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CORYN
Middle Name:MONTALTO
Last Name:RODRIGUE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 DESTREHAN DR
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-5061
Mailing Address - Country:US
Mailing Address - Phone:504-460-2099
Mailing Address - Fax:
Practice Address - Street 1:1111 MEDICAL CENTER BLVD STE S350
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3186
Practice Address - Country:US
Practice Address - Phone:504-349-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA234372363LF0000X, 207RC0001X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health