Provider Demographics
NPI:1417201898
Name:TRUDEAUX, DESHANNA NICOLE (LPN)
Entity Type:Individual
Prefix:
First Name:DESHANNA
Middle Name:NICOLE
Last Name:TRUDEAUX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 KILLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5423
Mailing Address - Country:US
Mailing Address - Phone:504-344-4385
Mailing Address - Fax:
Practice Address - Street 1:2132 KILLINGTON DR
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5423
Practice Address - Country:US
Practice Address - Phone:504-344-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA210483164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse