Provider Demographics
NPI:1811203425
Name:ORTEGA, GERARDO E (CRNA)
Entity Type:Individual
Prefix:MR
First Name:GERARDO
Middle Name:E
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2820 NAPOLEON AVE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6969
Mailing Address - Country:US
Mailing Address - Phone:504-899-1114
Mailing Address - Fax:504-891-3217
Practice Address - Street 1:2820 NAPOLEON AVE
Practice Address - Street 2:SUITE 650
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6969
Practice Address - Country:US
Practice Address - Phone:504-899-1114
Practice Address - Fax:504-891-3217
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06237367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08357570Medicaid
LA2120174Medicaid
MS08357570Medicaid