Provider Demographics
NPI:1154690394
Name:CONSOER, MONIQUE LEONA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:LEONA
Last Name:CONSOER
Suffix:
Gender:F
Credentials:APRN
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 1089
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1089
Mailing Address - Country:US
Mailing Address - Phone:985-892-7070
Mailing Address - Fax:985-892-7017
Practice Address - Street 1:16065 LAMONTE DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1405
Practice Address - Country:US
Practice Address - Phone:985-982-7070
Practice Address - Fax:985-892-7017
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06773363LA2200X
LARN064574163WM0102X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2190237Medicaid
LA3D044DP47Medicare Oscar/Certification