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General NPI Number Information
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NPI Number | 1083477814
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Entity Type | Organization
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Legal Business Name | NOLA CARE, LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 505
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5213
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Country | US
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Telephone | 905-701-3610
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Fax | 904-339-9752
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Provider Business Mailing Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 505
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5213
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Country | US
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Telephone | 904-701-3610
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Fax | 833-972-5105
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY ROUSSELL
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Credential | NP
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Telephone | 504-237-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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