Provider Demographics
NPI:1720502016
Name:MENESSES, RANDI MARIE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:RANDI
Middle Name:MARIE
Last Name:MENESSES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 NAPOLEON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-5541
Mailing Address - Country:US
Mailing Address - Phone:504-487-1153
Mailing Address - Fax:
Practice Address - Street 1:9605 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-2550
Practice Address - Country:US
Practice Address - Phone:504-739-9494
Practice Address - Fax:504-739-9495
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily