Provider Demographics
NPI:1063753499
Name:DELAHOUSSAYE, AIMEE D (FNP)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:D
Last Name:DELAHOUSSAYE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 N UNION ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6313
Mailing Address - Country:US
Mailing Address - Phone:337-678-3085
Mailing Address - Fax:337-678-0627
Practice Address - Street 1:823 N UNION ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6313
Practice Address - Country:US
Practice Address - Phone:337-678-3085
Practice Address - Fax:337-678-0627
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily