Provider Demographics
NPI:1619471406
Name:MORAN, AIMEE LANDRY (MD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:LANDRY
Last Name:MORAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:ELIZABETH
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:114 LA-403
Mailing Address - Street 2:
Mailing Address - City:PAINCOURTVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70391
Mailing Address - Country:US
Mailing Address - Phone:985-369-6070
Mailing Address - Fax:985-369-3514
Practice Address - Street 1:114 LA-403
Practice Address - Street 2:
Practice Address - City:PAINCOURTVILLE
Practice Address - State:LA
Practice Address - Zip Code:70391
Practice Address - Country:US
Practice Address - Phone:985-369-6070
Practice Address - Fax:985-369-3514
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA321056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine