Basic Information
| Provider Information | |||||||||
| NPI: | 1972080505 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAGE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | CATHERINE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 TULANE AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701197400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048212601 | ||||||||
| FaxNumber: | 5042673014 | ||||||||
| Practice Location | |||||||||
| Address1: | 3308 TULANE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701197100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048212601 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2018 | ||||||||
| LastUpdateDate: | 07/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | AP10162 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.