Provider Demographics
NPI:1770586323
Name:WIRFS, MARI JESSICA (MN, PHD, BCFNP)
Entity type:Individual
Prefix:DR
First Name:MARI
Middle Name:JESSICA
Last Name:WIRFS
Suffix:
Gender:F
Credentials:MN, PHD, BCFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:8840 WESTGATE ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-5452
Mailing Address - Country:US
Mailing Address - Phone:504-467-5540
Mailing Address - Fax:504-816-8596
Practice Address - Street 1:3939 GENTILLY BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-4858
Practice Address - Country:US
Practice Address - Phone:504-816-8596
Practice Address - Fax:504-816-8452
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily