Provider Demographics
NPI:1255759593
Name:CLOWER, RENEE MCGARRY (AG-ACNP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:MCGARRY
Last Name:CLOWER
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 PRYTANIA STREET
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-897-4425
Mailing Address - Fax:504-896-5249
Practice Address - Street 1:3434 PRYTANIA STREET
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-897-4425
Practice Address - Fax:504-896-5249
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07734363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2385267Medicaid