Provider Demographics
NPI:1457072704
Name:FALGOUT, PAIGE ORA (CNM)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ORA
Last Name:FALGOUT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 RUE DE LA VIE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUTE
Mailing Address - State:LA
Mailing Address - Zip Code:70817
Mailing Address - Country:US
Mailing Address - Phone:225-761-1200
Mailing Address - Fax:225-761-1215
Practice Address - Street 1:277 RUE DE LA VIE ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-5133
Practice Address - Country:US
Practice Address - Phone:225-761-1200
Practice Address - Fax:225-761-1215
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA227283367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife