Provider Demographics
NPI: | 1942456660 |
---|---|
Name: | BATTLEY, TOUSSAINT III (APRN, FNP-BC) |
Entity type: | Individual |
Prefix: | MR |
First Name: | TOUSSAINT |
Middle Name: | |
Last Name: | BATTLEY |
Suffix: | III |
Gender: | M |
Credentials: | APRN, FNP-BC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1690 MIRABEAU AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW ORLEANS |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70122 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 318-564-0418 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5246 BRITTANY DR |
Practice Address - Street 2: | |
Practice Address - City: | BATON ROUGE |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70808-9136 |
Practice Address - Country: | US |
Practice Address - Phone: | 225-757-4080 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-08-13 |
Last Update Date: | 2024-07-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
LA | AP05556 | 363LF0000X |
390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | |
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
LA | 1331252 | Medicaid | |
LA | A807D924 | Medicare PIN |