Provider Demographics
NPI:1861383671
Name:BOURGEOIS, FAITH N
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:N
Last Name:BOURGEOIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26152 BOBBY GILL RD W
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6531
Mailing Address - Country:US
Mailing Address - Phone:225-241-9374
Mailing Address - Fax:
Practice Address - Street 1:26152 BOBBY GILL RD W
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6531
Practice Address - Country:US
Practice Address - Phone:225-241-9374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program