MEDICARE: DEE MOREAU APRN

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
1	363LF0000X	Family Nurse Practitioner	AP141847	TX
2	363LF0000X	Family Nurse Practitioner	227592	LA

General Provider Information

NPI Number	:	1407416266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEE MOREAU APRN

Provider Business Mailing Address
First Line	:	305 TINA RENEE CIR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-6732
Country	:	US
Telephone Number	:	682-429-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 TINA RENEE CIR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-6732
Country	:	US
Telephone Number	:	682-429-4619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2019
Last Update Date	:	10/09/2023

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Directions to “ DEE MOREAU APRN” Practice Location

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