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NPI Code Detail

MEDICARE: CODI ROUSSELL FIELDS FNP

MEDICARE: CODI ROUSSELL FIELDS 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
1363L00000XNurse Practitioner234283LA

General Provider Information

NPI Number : 1801658984
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODI ROUSSELL FIELDS FNP
Provider Business Mailing Address
First Line : 1381 AUDUBON PKWY
Second Line :
City : MADISONVILLE
State : LA
Zip : 70447-3271
Country : US
Telephone Number : 985-768-6600
Fax Number :
Provider Business Practice Location Address
First Line : 3333 PONTCHARTRAIN DR
Second Line :
City : SLIDELL
State : LA
Zip : 70458-4827
Country : US
Telephone Number : 985-768-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2024
Last Update Date : 01/25/2024

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Directions to “ CODI ROUSSELL FIELDS FNP” Practice Location

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