Healthcare Provider Details

I. General information

NPI: 1083244347
Provider Name (Legal Business Name): BRIANNE FRUGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2020
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 GRANDLAKE BLVD APT E304
KENNER LA
70065-6521
US

IV. Provider business mailing address

650 POYDRAS ST STE 1400
NEW ORLEANS LA
70130-6116
US

V. Phone/Fax

Practice location:
  • Phone: 337-280-9699
  • Fax:
Mailing address:
  • Phone: 323-205-7088
  • Fax: 833-419-0181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15754
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: