Provider Demographics
NPI:1225021207
Name:PRATT, WENDY ANNE (APRN - FNP)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ANNE
Last Name:PRATT
Suffix:
Gender:F
Credentials:APRN - FNP
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:PRATT
Other - Last Name:GRANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN - FNP
Mailing Address - Street 1:1203 S TYLER ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-2353
Mailing Address - Country:US
Mailing Address - Phone:985-892-9143
Mailing Address - Fax:985-892-9656
Practice Address - Street 1:1203 S TYLER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-892-9143
Practice Address - Fax:985-892-9656
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN094158 AP04160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1464562Medicaid
352323ZADSOtherMEDICARE
LA1464562Medicaid