Individual
MRS. HEATHER LYNN FANGUY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
259 GABASSE ST, HOUMA, LA 70360-4417
(985) 873-7244
(985) 876-2111
Mailing address
259 GABASSE ST, HOUMA, LA 70360-4417
(985) 873-7244
(985) 876-2111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP05565
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307084
—
LA
Enumeration date
08/14/2008
Last updated
08/12/2014
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