Basic Information
| Provider Information | |||||||||
| NPI: | 1376546887 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DESHOTELS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1575 CALHOUN ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701186153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048950853 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3900 S CARROLLTON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701184712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044820084 | ||||||||
| FaxNumber: | 5044836016 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 142 8493 | 05 | LA | MEDICAID |