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NPI Code Detail

MEDICARE: ASHLEY TERRITO POURCIAU FNP

MEDICARE: ASHLEY TERRITO POURCIAU FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP07361LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265873939
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY TERRITO POURCIAU FNP
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-713-2400
Fax Number : 225-765-9196
Provider Business Practice Location Address
First Line : 310 DUREL DR
Second Line :
City : NEW ROADS
State : LA
Zip : 70760-2973
Country : US
Telephone Number : 225-713-2400
Fax Number : 225-713-2405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2013
Last Update Date : 04/14/2022

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