Basic Information
Provider Information
NPI: 1366637464
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARNER-SMITH
FirstName: ANGELA
MiddleName: CASSANDRA
NamePrefix:  
NameSuffix:  
Credential: APRN, NNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HENRY CLAY AVE
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701185798
CountryCode: US
TelephoneNumber: 5048999511
FaxNumber:  
Practice Location
Address1: 200 HENRY CLAY AVE
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701185798
CountryCode: US
TelephoneNumber: 5048999511
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/11/2007
LastUpdateDate: 11/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAP02914LAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LN0005XAP02914LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care

No ID Information.


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