Bourg, Tracy B

Bourg, Tracy B is an individual health care provider with primary practice located at 3909 Lapalco Blvd Suite 100, Harvey LA 70058-2302. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Bourg, Tracy B can be contacted via phone (504) 349-6900.

Contact Information

Primary practice address
3909 Lapalco Blvd Suite 100 Harvey LA 70058-2302
Phone: (504) 349-6900
Fax: (504) 340-4305
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1964 Louisiana

Profile Details

NPI number 1871744854
LBN Legal business name Bourg, Tracy B
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2008
Last updated Oct 8th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871744854 NPPES
Louisiana Other 1964 TEMP NP LICENSE

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