Provider Demographics
NPI:1306724893
Name:DEBOUSE, NURIDEEN
Entity type:Individual
Prefix:
First Name:NURIDEEN
Middle Name:
Last Name:DEBOUSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GIBBS DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-4414
Mailing Address - Country:US
Mailing Address - Phone:504-408-6007
Mailing Address - Fax:
Practice Address - Street 1:2 GIBBS DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4414
Practice Address - Country:US
Practice Address - Phone:504-408-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator