Provider Demographics
NPI:1659781664
Name:PORCHE, BRANDI DUFFOURC (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:DUFFOURC
Last Name:PORCHE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MISS
Other - First Name:BRANDI
Other - Middle Name:LYNN
Other - Last Name:DUFFOURC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 MARYLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070
Mailing Address - Country:US
Mailing Address - Phone:504-349-6900
Mailing Address - Fax:504-340-4305
Practice Address - Street 1:107 MARYLAND DRIVE
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070
Practice Address - Country:US
Practice Address - Phone:504-349-6900
Practice Address - Fax:504-340-4305
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily