Provider Demographics
NPI:1790482248
Name:PADUA ESGUERRA, DIONE NICHOLE
Entity Type:Individual
Prefix:
First Name:DIONE
Middle Name:NICHOLE
Last Name:PADUA ESGUERRA
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 1:564 TERRY PKWY
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-4047
Mailing Address - Country:US
Mailing Address - Phone:504-339-9626
Mailing Address - Fax:
Practice Address - Street 1:1101 MEDICAL CENTER BVLD
Practice Address - Street 2:N116
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-349-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.024707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist