MEDICARE: ERIN LAGROUE NP

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	RN109784-AP06169	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1538471495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN LAGROUE NP

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	:	225-526-0011
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	5000 ODONAVAN BLVD STE 404
Second Line	:
City	:	WALKER
State	:	LA
Zip	:	70785-6355
Country	:	US
Telephone Number	:	225-369-8100
Fax Number	:	225-369-8140

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

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	12/29/2020

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