Healthcare Provider Details

I. General information

NPI: 1508789421
Provider Name (Legal Business Name): WEST JEFFERSON MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MEDICAL CENTER BLVD
MARRERO LA
70072-3151
US

IV. Provider business mailing address

1111 MEDICAL CENTER BLVD
MARRERO LA
70072-3151
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-1570
  • Fax: 504-349-1448
Mailing address:
  • Phone: 504-349-1570
  • Fax: 504-349-1448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. NICOLE AUTIN CHIASSON
Title or Position: FNP, INTERVENTIONAL RADIOLOGY
Credential: FNP
Phone: 504-349-1570