Provider Demographics
NPI:1225695752
Name:GUERIN, ROGER (FNP)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:
Last Name:GUERIN
Suffix:
Gender:M
Credentials:FNP
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 894
Mailing Address - Street 2:
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-0894
Mailing Address - Country:US
Mailing Address - Phone:225-718-8351
Mailing Address - Fax:
Practice Address - Street 1:RIVER PLACE BEHAVIORAL HOSPITAL
Practice Address - Street 2:500 RUE DE SANTE RD.
Practice Address - City:LAPLACE
Practice Address - State:LA
Practice Address - Zip Code:70068
Practice Address - Country:US
Practice Address - Phone:985-444-5151
Practice Address - Fax:985-444-5117
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200857363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily