Provider Demographics
NPI:1588198212
Name:BLEREAU, MARCIA ANN (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:ANN
Last Name:BLEREAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:MARCIA
Other - Middle Name:BLEREAU
Other - Last Name:DENNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1302 LAKEWOOD DR STE 200
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1885
Practice Address - Country:US
Practice Address - Phone:985-380-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2472291Medicaid