Provider Demographics
NPI:1184089492
Name:PAISLEY FAMILY MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:PAISLEY FAMILY MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:DANNETTE
Authorized Official - Last Name:BARCONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,MPH,APRN,FNP-C
Authorized Official - Phone:504-962-9705
Mailing Address - Street 1:4910 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-1116
Mailing Address - Country:US
Mailing Address - Phone:504-390-0539
Mailing Address - Fax:504-322-2622
Practice Address - Street 1:4301 ELYSIAN FIELDS AVE STE 103
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-7403
Practice Address - Country:US
Practice Address - Phone:504-962-9705
Practice Address - Fax:504-962-9707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2412108Medicaid
LA1032239Medicaid