Provider Demographics
NPI:1750014064
Name:ROGER, MARCI (NP)
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:
Last Name:ROGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARCI
Other - Middle Name:
Other - Last Name:MILLET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:148 WALL BLVD
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7107
Mailing Address - Country:US
Mailing Address - Phone:504-417-2134
Mailing Address - Fax:
Practice Address - Street 1:148 WALL BLVD
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7107
Practice Address - Country:US
Practice Address - Phone:504-393-2775
Practice Address - Fax:504-393-2744
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily