Healthcare Provider Details

I. General information

NPI: 1699553008
Provider Name (Legal Business Name): MS. ROSEAN M PORTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6940 CURRAN BLVD
NEW ORLEANS LA
70126
US

IV. Provider business mailing address

11309 CLOVER KNOLL DR
COVINGTON LA
70433-7375
US

V. Phone/Fax

Practice location:
  • Phone: 504-812-6390
  • Fax:
Mailing address:
  • Phone: 504-813-5587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: