Provider Demographics
NPI:1831775246
Name:GONZALEZ, FELICIA MCCANTS (FNP)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:MCCANTS
Last Name:GONZALEZ
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 1:11921 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6016
Mailing Address - Country:US
Mailing Address - Phone:225-485-2154
Mailing Address - Fax:
Practice Address - Street 1:203 ALLENDALE DR
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-3219
Practice Address - Country:US
Practice Address - Phone:225-389-1311
Practice Address - Fax:225-389-1330
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA218492363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care