Individual
TIFFANIE BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2450 SEVERN AVE STE 315, METAIRIE, LA 70001-6949
(504) 834-1655
Mailing address
203 REMY DR, LA PLACE, LA 70068-5932
(985) 212-9604
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
207715
LA
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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