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
-
Ronald Earl Brown II, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
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
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- 360 Wellness LLC
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- A D Walker Jr MD Apmc
- Richard Paul Abben
- Fadi F Abou-Issa
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All providers in Houma, LA · Psychiatric/Mental Health Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.