Provider Demographics
NPI:1912735119
Name:WEATHERSPOON, LARRION NICOLE (FNP)
Entity type:Individual
Prefix:
First Name:LARRION
Middle Name:NICOLE
Last Name:WEATHERSPOON
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 1:1713 BIRCHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6752
Mailing Address - Country:US
Mailing Address - Phone:504-452-2964
Mailing Address - Fax:
Practice Address - Street 1:1668 HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-6375
Practice Address - Country:US
Practice Address - Phone:985-401-4022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA236446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily