Individual
JANET ROUSSELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40430 E I55 SVC RD #40, PONCHATOULA, LA 70454
(985) 507-4584
Mailing address
40430 E I55 SERVICE RD #40, PONCHATOULA, LA 70454
(985) 507-4584
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN109592
LA
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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