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NPI Code Detail

MEDICARE: WILLIAM DUREAU DART JR. FNP

MEDICARE: WILLIAM DUREAU DART JR. FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP05303LA
2363L00000XNurse PractitionerAP05303LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P00736280OTHERLARAILROAD THRU PEPA

General Provider Information

NPI Number : 1194904193
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM DUREAU DART JR. FNP
Provider Business Mailing Address
First Line : 2051 SILVERSIDE DR
Second Line : SUITE 260
City : BATON ROUGE
State : LA
Zip : 70808-9005
Country : US
Telephone Number : 225-490-6309
Fax Number : 225-765-9291
Provider Business Practice Location Address
First Line : 5439 AIRLINE HWY
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-1712
Country : US
Telephone Number : 225-765-7163
Fax Number : 225-765-7164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2007
Last Update Date : 03/25/2021

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