Provider Demographics
NPI:1366705634
Name:ST.AMANT, SCOTT JOSEPH (APRN)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:JOSEPH
Last Name:ST.AMANT
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 MARINERS PLAZA DR
Mailing Address - Street 2:SUITE 504
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-6821
Mailing Address - Country:US
Mailing Address - Phone:985-246-1250
Mailing Address - Fax:985-246-1251
Practice Address - Street 1:500 MARINERS PLAZA DR
Practice Address - Street 2:SUITE 504
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-6821
Practice Address - Country:US
Practice Address - Phone:985-246-1250
Practice Address - Fax:985-246-1251
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA89100163WE0003X
LAAPO6828363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2352032Medicaid
LA2362917OtherMEDICAID IP-LIMITED MEDICAID ENROLLMENT FOR EHR PROGRAM