Provider Demographics
NPI:1790559425
Name:RIDEAUX, ANGELICA D (DOULA)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:D
Last Name:RIDEAUX
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 EADS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5828
Mailing Address - Country:US
Mailing Address - Phone:337-321-2692
Mailing Address - Fax:
Practice Address - Street 1:3129 EADS ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5828
Practice Address - Country:US
Practice Address - Phone:337-321-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula