Individual
BRAD BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 WESTBANK EXPY, GRETNA, LA 70053-5616
(504) 364-1844
Mailing address
315 WESTBANK EXPY, GRETNA, LA 70053-5616
(504) 364-1844
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP08638
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2416243
—
LA
Enumeration date
03/22/2016
Last updated
04/30/2025
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