Provider Demographics
NPI:1629580030
Name:HOPE, CHARLISE (NP-C)
Entity Type:Individual
Prefix:
First Name:CHARLISE
Middle Name:
Last Name:HOPE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CHARLISE
Other - Middle Name:
Other - Last Name:HOPE-PORCHE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:1400 TECHE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-5843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 TECHE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-5843
Practice Address - Country:US
Practice Address - Phone:504-361-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA