Provider Demographics
NPI:1518218478
Name:LISA BYRD HEALTHCARE INC OF LOUISIANA
Entity Type:Organization
Organization Name:LISA BYRD HEALTHCARE INC OF LOUISIANA
Other - Org Name:LBH OF LOUISIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, FNP, GNP
Authorized Official - Phone:601-941-5497
Mailing Address - Street 1:201 SAINT CHARLES AVE
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70170-1000
Mailing Address - Country:US
Mailing Address - Phone:601-866-7723
Mailing Address - Fax:601-866-7773
Practice Address - Street 1:201 SAINT CHARLES AVE
Practice Address - Street 2:SUITE 2500
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70170-1000
Practice Address - Country:US
Practice Address - Phone:601-866-7723
Practice Address - Fax:601-866-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty