Provider Demographics
NPI:1093433229
Name:DUGAS, ROSS MICHAEL (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:MICHAEL
Last Name:DUGAS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:LOREAUVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70552-0278
Mailing Address - Country:US
Mailing Address - Phone:337-229-8288
Mailing Address - Fax:337-229-4065
Practice Address - Street 1:411 SOUTH MAIN STEET
Practice Address - Street 2:
Practice Address - City:LOREAUVILLE
Practice Address - State:LA
Practice Address - Zip Code:70552
Practice Address - Country:US
Practice Address - Phone:337-229-8288
Practice Address - Fax:337-229-4065
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA227028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty