Individual
DEANNA IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 768-2164
(833) 756-2680
Mailing address
10101 PARK ROWE AVE STE 200, BATON ROUGE, LA 70810-1685
(225) 769-2200
(833) 756-2680
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
210673
LA
363LF0000X
Family Nurse Practitioner
Primary
210673
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210673
NP LICENSE NUMBER
LA
Enumeration date
08/18/2022
Last updated
03/31/2023
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