Provider Demographics
NPI:1871992305
Name:BECNEL, MIRIAM FERRAND (PA)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:FERRAND
Last Name:BECNEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:MIRIAM
Other - Middle Name:HANNAH
Other - Last Name:FERRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2218 BURDETTE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-4206
Mailing Address - Country:US
Mailing Address - Phone:504-810-6110
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200739363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2377841Medicaid
MS09084825Medicaid
LA2377841Medicaid