Individual
MARJORIE STEPHANIE ROSEBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P
Contact information
Practice address
2750 GAUSE BLVD E, SLIDELL, LA 70461-4149
(985) 639-3777
(985) 639-3725
Mailing address
2750 GAUSE BLVD E, SLIDELL, LA 70461-4149
(985) 639-3777
(985) 639-3725
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209007497
IL
363LF0000X
Family Nurse Practitioner
Primary
AP08230
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02907034
—
MS
05
—
2398555
—
LA
Enumeration date
02/25/2009
Last updated
11/09/2015
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