Provider Demographics
NPI:1922017078
Name:WAGUESPACK, FRANCINE LOUISE (NP)
Entity Type:Individual
Prefix:MRS
First Name:FRANCINE
Middle Name:LOUISE
Last Name:WAGUESPACK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:FRANCINE
Other - Middle Name:LOUISE
Other - Last Name:WAGUESPACK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:21420 HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:VACHERIE
Mailing Address - State:LA
Mailing Address - Zip Code:70090-3614
Mailing Address - Country:US
Mailing Address - Phone:225-265-3010
Mailing Address - Fax:225-265-3775
Practice Address - Street 1:21420 HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:VACHERIE
Practice Address - State:LA
Practice Address - Zip Code:70090-3614
Practice Address - Country:US
Practice Address - Phone:225-265-3013
Practice Address - Fax:225-265-3775
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN03411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1113374Medicaid