Provider Demographics
NPI:1073210464
Name:ROUSSE, DARIAN SCURLOCK (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DARIAN
Middle Name:SCURLOCK
Last Name:ROUSSE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 SAINT GEORGE ROAD
Mailing Address - Street 2:
Mailing Address - City:SCHRIEVER
Mailing Address - State:LA
Mailing Address - Zip Code:70395
Mailing Address - Country:US
Mailing Address - Phone:985-856-3633
Mailing Address - Fax:
Practice Address - Street 1:404 N ACADIA RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4856
Practice Address - Country:US
Practice Address - Phone:985-447-3889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily