Provider Demographics
NPI:1669155941
Name:SIMONEAUX, MEAGAN G (FNP)
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:G
Last Name:SIMONEAUX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 ALLENE ST
Mailing Address - Street 2:
Mailing Address - City:BRUSLY
Mailing Address - State:LA
Mailing Address - Zip Code:70719-2063
Mailing Address - Country:US
Mailing Address - Phone:225-413-9245
Mailing Address - Fax:
Practice Address - Street 1:8888 SUMMA AVE # 4
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3772
Practice Address - Country:US
Practice Address - Phone:225-413-9245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA139390163W00000X
LA234545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse