Provider Demographics
NPI:1184143315
Name:WESTCOTT, AMANDA ALLAIN (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ALLAIN
Last Name:WESTCOTT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 BAYOU RD
Mailing Address - Street 2:
Mailing Address - City:SAINT BERNARD
Mailing Address - State:LA
Mailing Address - Zip Code:70085-4914
Mailing Address - Country:US
Mailing Address - Phone:504-390-5241
Mailing Address - Fax:
Practice Address - Street 1:6225 S CLAIBORNE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4105
Practice Address - Country:US
Practice Address - Phone:504-864-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily