Healthcare Provider Details

I. General information

NPI: 1417385188
Provider Name (Legal Business Name): VANESSA BRASS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CROSLEY ST
WEST MONROE LA
71291-2913
US

IV. Provider business mailing address

101 CROSLEY ST
WEST MONROE LA
71291-2913
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-1192
  • Fax: 318-325-1222
Mailing address:
  • Phone: 318-325-1192
  • Fax: 318-325-1222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07526
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA003989
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP07526
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: