Provider Demographics
NPI:1902288475
Name:PEDERSEN-MULLER, PAIGE LAUREN (APRN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:LAUREN
Last Name:PEDERSEN-MULLER
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:37976 LA HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-0334
Mailing Address - Country:US
Mailing Address - Phone:225-658-1303
Mailing Address - Fax:225-658-1304
Practice Address - Street 1:33716 LA HIGHWAY 16 STE D
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70706-0968
Practice Address - Country:US
Practice Address - Phone:225-938-4121
Practice Address - Fax:225-938-4121
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAP08318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2400614Medicaid