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NPI Code Detail

MEDICARE: REAGAN ELIZABETH BOURGEOIS RN

MEDICARE: REAGAN ELIZABETH BOURGEOIS RN
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
1163W00000XRegistered Nurse206803LA

General Provider Information

NPI Number : 1538011945
Entity Type Code : Individual
Provider Name (Legal Business Name) : REAGAN ELIZABETH BOURGEOIS RN
Provider Business Mailing Address
First Line : 3082 LYONS RD
Second Line :
City : LAKE ARTHUR
State : LA
Zip : 70549-5233
Country : US
Telephone Number : 337-529-0335
Fax Number :
Provider Business Practice Location Address
First Line : 711 DR MICHAEL DEBAKEY DR
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-5785
Country : US
Telephone Number : 337-419-1958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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