4Connor LLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Houma, LA

NPI 1013797133 · NPPES record last updated Jun 11, 2024

Key facts

NPI
1013797133
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
4CONNOR LLC
Practice address
96 Valhi Blvd
Houma, LA 70360-6074
Phone
(985) 790-2112
NPI assigned
Oct 5, 2023
Organization subpart
No

Authorized official

Name
Ronald Brown
Title
Owner
Phone
(985) 635-6943

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240116003536 LA Part B Supplier - Clinic/Group Practice 2769834654 Receives reassigned benefits from 1 practitioner
Practice locations: Houma, LA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

96 Valhi Blvd
Houma, LA 70360-6074

Mailing address

96 Valhi Blvd
Houma, LA 70360-6074
Phone (985) 790-2112

Other providers in Houma, LA

All providers in Houma, LA · Psychiatric/Mental Health Nurse Practitioner in Louisiana

Sources for this page

Verify at the official NPI Registry.