Provider Demographics
NPI:1992085799
Name:LOUSTEAU, BLAIR O (FNP)
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:O
Last Name:LOUSTEAU
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 1:9418 BROOKLINE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1428
Mailing Address - Country:US
Mailing Address - Phone:225-490-6309
Mailing Address - Fax:225-765-9291
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 7000
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-765-8829
Practice Address - Fax:225-765-8283
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP 06566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily