Provider Demographics
NPI:1154965374
Name:FACIANNE, PAULETTE
Entity type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:FACIANNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6408 ARTS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5604
Mailing Address - Country:US
Mailing Address - Phone:504-723-6896
Mailing Address - Fax:
Practice Address - Street 1:6408 ARTS ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5604
Practice Address - Country:US
Practice Address - Phone:504-723-6896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator