Provider Demographics
NPI:1073193272
Name:ORMAND, MARISSA
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:
Last Name:ORMAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-5117
Mailing Address - Country:US
Mailing Address - Phone:254-319-7200
Mailing Address - Fax:
Practice Address - Street 1:700 PUJO ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4378
Practice Address - Country:US
Practice Address - Phone:337-436-6622
Practice Address - Fax:337-436-4403
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant