Provider Demographics
NPI:1811961311
Name:BARCONEY, MONIQUE DANNETTE (DNP, MPH, APRN, FNP-)
Entity type:Individual
Prefix:MISS
First Name:MONIQUE
Middle Name:DANNETTE
Last Name:BARCONEY
Suffix:
Gender:F
Credentials:DNP, MPH, APRN, FNP-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:504-962-9707
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
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2412108Medicaid
LA1032239Medicaid