Provider Demographics
NPI:1003603929
Name:RUFFIN-BRISCO, NAYDEAN LASHON
Entity type:Individual
Prefix:DR
First Name:NAYDEAN
Middle Name:LASHON
Last Name:RUFFIN-BRISCO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:NAYDEAN
Other - Middle Name:LASHON
Other - Last Name:BRISCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN AND APRN LICENSE
Mailing Address - Street 1:2304 S TURNBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-5413
Mailing Address - Country:US
Mailing Address - Phone:225-425-9755
Mailing Address - Fax:
Practice Address - Street 1:9282 DELTA PLACE RD
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760
Practice Address - Country:US
Practice Address - Phone:225-242-9751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA240146363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty