Provider Demographics
NPI:1942262761
Name:VOSBURG, MONICA W (RN/APN)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:W
Last Name:VOSBURG
Suffix:
Gender:F
Credentials:RN/APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 N RANGE AVE
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-2411
Mailing Address - Country:US
Mailing Address - Phone:225-665-6677
Mailing Address - Fax:225-665-0055
Practice Address - Street 1:1213 N RANGE AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2411
Practice Address - Country:US
Practice Address - Phone:225-665-6677
Practice Address - Fax:225-665-0055
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA087149363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1368261Medicaid