Provider Demographics
NPI:1134791635
Name:ROHNER, BECKY GUNN (FNP)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:GUNN
Last Name:ROHNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:LYNN
Other - Last Name:GUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1320 MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4886
Mailing Address - Country:US
Mailing Address - Phone:985-446-2021
Mailing Address - Fax:985-447-1546
Practice Address - Street 1:1320 MARTIN LUTHER KING DR
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4886
Practice Address - Country:US
Practice Address - Phone:985-446-2021
Practice Address - Fax:985-447-1546
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA220852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily