| 17 Eme - Empower Motivate Elevate | |
|
14497 Vicaro Lane Hammond LA 70401 | |
| (504) 202-0076 | |
| (949) 577-4299 |
| Full Name | 17 Eme - Empower Motivate Elevate |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 14497 Vicaro Lane, Hammond, Louisiana |
| Authorized Official Name and Position | Celeste Gunning (OWNER/OPERATOR/PROVIDER) |
| Authorized Official Contact | 5042020076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 17 Eme - Empower Motivate Elevate 14497 Vicaro Lane Hammond LA 70401 Ph: (504) 202-0076 | 17 Eme - Empower Motivate Elevate 14497 Vicaro Lane Hammond LA 70401 Ph: (504) 202-0076 |
| NPI Number | 1902529704 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 05/24/2023 |
| Certification Date | 05/24/2023 |
| Medicare PECOS PAC ID | 6507210721 |
|---|---|
| Medicare Enrollment ID | O20230921002998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902529704 | NPI | - | NPPES |
| Provider Name | Celeste Renee Gunning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699329409 PECOS PAC ID: 4385974450 Enrollment ID: I20191003000086 |
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