Provider Demographics
NPI:1891832002
Name:STAMPS, CHARLENE B (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:B
Last Name:STAMPS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 S TONTI ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4453
Mailing Address - Country:US
Mailing Address - Phone:504-821-2293
Mailing Address - Fax:
Practice Address - Street 1:ST. CHARLES PARISH HOSPITAL
Practice Address - Street 2:1057 PAUL MAILLARD RD.
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070
Practice Address - Country:US
Practice Address - Phone:985-785-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1391140Medicaid
LA1391140Medicaid