Active NPI
Phyllis Waguespack, R.N.
- Psychiatric/Mental Health Registered Nurse
- La Place, LA
National Provider Identifier
1609156397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- RN042692
- Practice address
- 1809 W Airline Hwy
La Place, LA 70068-3336 - Phone
- (985) 652-8444
- NPI assigned
- Aug 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN042692 | LA | Primary |
Addresses
Primary practice location
1809 W Airline Hwy
La Place, LA 70068-3336
Mailing address
1809 W Airline Hwy
La Place, LA 70068-3336
Phone (985) 652-8444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN042692 | LA | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314230400000",
"number": "1609156397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1809 W AIRLINE HWY",
"city": "LA PLACE",
"state": "LA",
"postal_code": "700683336",
"telephone_number": "985-652-8444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 W AIRLINE HWY",
"city": "LA PLACE",
"state": "LA",
"postal_code": "700683336",
"telephone_number": "985-652-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGUESPACK",
"first_name": "PHYLLIS",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-25",
"last_updated": "2011-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "LA",
"license": "RN042692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Place, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.