Basic Information
| Provider Information | |||||||||
| NPI: | 1982361630 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRICE | ||||||||
| FirstName: | ADREANN | ||||||||
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| Credential: | RT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1536 | ||||||||
| Address2: | |||||||||
| City: | MANDEVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704701536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9856356943 | ||||||||
| FaxNumber: | 9852316733 | ||||||||
| Practice Location | |||||||||
| Address1: | 69164 HWY 59 STE 4 | ||||||||
| Address2: | |||||||||
| City: | MANDVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493242020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2021 | ||||||||
| LastUpdateDate: | 02/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471S1302X | 189993 | LA | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Sonography |
No ID Information.