Healthcare Provider Details

I. General information

NPI: 1417763723
Provider Name (Legal Business Name): MEGAN VETTER BRUGES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 HIGHWAY 190 E
HAMMOND LA
70401-8510
US

IV. Provider business mailing address

2511 HIGHWAY 190 E
HAMMOND LA
70401-8510
US

V. Phone/Fax

Practice location:
  • Phone: 985-543-6800
  • Fax: 985-543-6801
Mailing address:
  • Phone: 985-543-6800
  • Fax: 985-543-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number238939
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: