Provider Demographics
NPI:1245837897
Name:LANDECHE, ASHLEY ST ROMAIN (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ST ROMAIN
Last Name:LANDECHE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:DANIELLE
Other - Last Name:ST. ROMAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 DUNN ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4440
Mailing Address - Country:US
Mailing Address - Phone:985-876-0300
Mailing Address - Fax:985-876-5529
Practice Address - Street 1:225 DUNN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4440
Practice Address - Country:US
Practice Address - Phone:985-876-0300
Practice Address - Fax:985-876-5529
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA215014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily