Healthcare Provider Details

I. General information

NPI: 1972438091
Provider Name (Legal Business Name): MEAGAN GONZALEZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 MEDICAL PARK DR
MONROE LA
71203-2354
US

IV. Provider business mailing address

404 PELICAN GROVE DR
CALHOUN LA
71225-8600
US

V. Phone/Fax

Practice location:
  • Phone: 318-690-0662
  • Fax:
Mailing address:
  • Phone: 318-372-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number247629
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: