Provider Demographics
NPI:1033550686
Name:BAROUSSE, MEGAN (FNP)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:BAROUSSE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 JESSIE RICHARD RD
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-5250
Mailing Address - Country:US
Mailing Address - Phone:337-230-6535
Mailing Address - Fax:337-668-4386
Practice Address - Street 1:376 MAIN ST
Practice Address - Street 2:
Practice Address - City:CANKTON
Practice Address - State:LA
Practice Address - Zip Code:70584-5920
Practice Address - Country:US
Practice Address - Phone:337-668-4141
Practice Address - Fax:337-668-4386
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO7344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily