Provider Demographics
NPI:1972133742
Name:BGDNP,LLC
Entity type:Organization
Organization Name:BGDNP,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / FNP
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:G
Authorized Official - Last Name:LAGASSE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:985-951-9932
Mailing Address - Street 1:513 KRISTIAN CT
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3716
Mailing Address - Country:US
Mailing Address - Phone:985-951-9932
Mailing Address - Fax:985-871-9094
Practice Address - Street 1:513 KRISTIAN CT
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-3716
Practice Address - Country:US
Practice Address - Phone:985-951-9932
Practice Address - Fax:985-871-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty