Provider Demographics
NPI:1578964714
Name:MARCOTTE, BRIDGETTE (FNP)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:MARCOTTE
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:PO BOX 13030
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71315-3030
Mailing Address - Country:US
Mailing Address - Phone:318-445-9331
Mailing Address - Fax:318-619-6899
Practice Address - Street 1:176 VERSAILLES BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2493
Practice Address - Country:US
Practice Address - Phone:318-445-9331
Practice Address - Fax:318-619-6899
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07976363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2386638Medicaid