Provider Demographics
NPI:1417743196
Name:RICHARD, NATALIE QUEZERGUE (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:QUEZERGUE
Last Name:RICHARD
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 CHAMBERLAIN DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-2528
Mailing Address - Country:US
Mailing Address - Phone:504-315-8550
Mailing Address - Fax:
Practice Address - Street 1:1 DREXEL DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1056
Practice Address - Country:US
Practice Address - Phone:504-486-7411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant