Provider Demographics
NPI:1275090078
Name:DUCTAN-LOUIS, MARIE C (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:C
Last Name:DUCTAN-LOUIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15245 GOLDFINCH CIR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-7011
Mailing Address - Country:US
Mailing Address - Phone:786-537-5226
Mailing Address - Fax:
Practice Address - Street 1:13936 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-2908
Practice Address - Country:US
Practice Address - Phone:305-364-5778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3161492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily