Roseboom, Marjorie Stephanie
Roseboom, Marjorie Stephanie is an individual health care provider with primary practice located at 2750 Gause Blvd E , Slidell LA 70461-4149. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Roseboom, Marjorie Stephanie can be contacted via phone (985) 639-3777.Contact Information
Primary practice address
2750 Gause Blvd E
Slidell LA 70461-4149
Phone: (985) 639-3777
Fax: (985) 639-3725
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 209007497 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP08230 | Louisiana |
Profile Details
| NPI number | 1366682700 |
|---|---|
| LBN Legal business name | Roseboom, Marjorie Stephanie |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 25th, 2009 |
| Last updated | Nov 9th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366682700 | NPPES |
| Mississippi | MEDICAID | 02907034 | |
| Mississippi | MEDICAID | 2398555 |
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