Healthcare Provider Details

I. General information

NPI: 1942832324
Provider Name (Legal Business Name): LATONYA DARENSBOURG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 HOUMA BLVD STE 300
METAIRIE LA
70006-4203
US

IV. Provider business mailing address

3530 HOUMA BLVD STE 300
METAIRIE LA
70006-4203
US

V. Phone/Fax

Practice location:
  • Phone: 504-264-5142
  • Fax: 504-455-2648
Mailing address:
  • Phone: 504-264-5142
  • Fax: 504-455-2648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number211798
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: