Healthcare Provider Details

I. General information

NPI: 1316481310
Provider Name (Legal Business Name): YVETTE J. FALGOUST APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2016
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 UTICA ST
METAIRIE LA
70006-6578
US

IV. Provider business mailing address

2236 KENTUCKY AVE
KENNER LA
70062-5947
US

V. Phone/Fax

Practice location:
  • Phone: 504-457-3687
  • Fax:
Mailing address:
  • Phone: 504-234-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP08920
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License NumberRN071704
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: