MEDICARE: TREJON ANSHELLE BRIGNAC 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP09689	LA
2	363LF0000X	Family Nurse Practitioner	AP09689	LA

General Provider Information

NPI Number	:	1891285516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREJON ANSHELLE BRIGNAC NP

Provider Business Mailing Address
First Line	:	1515 POYDRAS ST STE 1070
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-4520
Country	:	US
Telephone Number	:	504-524-1210
Fax Number	:	504-524-1491

Provider Business Practice Location Address
First Line	:	9900 LAKE FOREST BLVD STE F
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2609
Country	:	US
Telephone Number	:	504-620-0500
Fax Number	:	504-620-0522

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

Provider Enumeration Date	:	05/17/2018
Last Update Date	:	11/03/2023

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