Healthcare Provider Details

I. General information

NPI: 1508408477
Provider Name (Legal Business Name): LAUREN DAVIS DUFOUR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2019
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N CAUSEWAY BLVD # 300
MANDEVILLE LA
70448-4664
US

IV. Provider business mailing address

110 NORTH DR
COVINGTON LA
70433-4809
US

V. Phone/Fax

Practice location:
  • Phone: 985-807-4364
  • Fax:
Mailing address:
  • Phone: 984-807-4364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number222183
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number059936
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: