Provider Demographics
NPI:1245821198
Name:GRANGER, LATOYA DUGAS (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:DUGAS
Last Name:GRANGER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 BERTRAND DR STE E4
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-9105
Mailing Address - Country:US
Mailing Address - Phone:337-294-8471
Mailing Address - Fax:
Practice Address - Street 1:1304 BERTRAND DR STE E4
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-9105
Practice Address - Country:US
Practice Address - Phone:337-356-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA218070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily