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Individual

ROSEMARY A STAGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN FNPC

Contact information

Practice address
23515 HWY 190, MANDEVILLE, LA 70448
(985) 626-6300
(985) 626-6530
Mailing address
PO BOX 3850, 23515 HWY 190, MANDEVILLE, LA 70470-3850
(985) 626-6300
(985) 626-6530

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN045195
LA
363L00000X
Nurse Practitioner
AP04281
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043264351
NPI FACILITY
LA
05
1169536
LA
Enumeration date
04/16/2007
Last updated
09/11/2025
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