Basic Information
| Provider Information | |||||||||
| NPI: | 1205077278 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALLEYN | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | LEMOINE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LEMOINE | ||||||||
| OtherFirstName: | AMANDA | ||||||||
| OtherMiddleName: | ANN | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 155 HOSPITAL DR STE 303 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705032852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372354460 | ||||||||
| FaxNumber: | 3372353060 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 HOSPITAL DR STE 303 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705032852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372354460 | ||||||||
| FaxNumber: | 3372353060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2009 | ||||||||
| LastUpdateDate: | 07/30/2013 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 204930 | LA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.