MEDICARE: ASHLEY ODENDAHL VARNADO

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	RN143503	LA

General Provider Information

NPI Number	:	1609725761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ODENDAHL VARNADO

Provider Business Mailing Address
First Line	:	9825 BANK STREET EXT
Second Line	:
City	:	CLINTON
State	:	LA
Zip	:	70722-3527
Country	:	US
Telephone Number	:	225-485-7823
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 BLUEBONNET BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-9643
Country	:	US
Telephone Number	:	225-766-8097
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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Directions to “ ASHLEY ODENDAHL VARNADO ” Practice Location

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