Provider Demographics
NPI:1346067410
Name:GARCIA, GLORIA INES (NP)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:INES
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:GLORIA
Other - Middle Name:INES
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:314 NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:LA
Mailing Address - Zip Code:70437-5504
Mailing Address - Country:US
Mailing Address - Phone:504-427-9274
Mailing Address - Fax:
Practice Address - Street 1:19317 N 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-9511
Practice Address - Country:US
Practice Address - Phone:504-427-9274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA237396363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily