Provider Demographics
NPI:1619650348
Name:WESTMORELAND, GEORGENA R
Entity Type:Individual
Prefix:
First Name:GEORGENA
Middle Name:R
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3748 GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-3326
Mailing Address - Country:US
Mailing Address - Phone:504-738-4157
Mailing Address - Fax:
Practice Address - Street 1:3303 TULANE AVE BLDG 3
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7186
Practice Address - Country:US
Practice Address - Phone:504-738-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker