Boudreaux, Misty

Boudreaux, Misty is an individual health care provider with primary practice located at 180 W Esplanade Ave , Kenner LA 70065-2467. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Boudreaux, Misty can be contacted via phone (504) 468-8600.

Contact Information

Primary practice address
180 W Esplanade Ave Kenner LA 70065-2467
Phone: (504) 468-8600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP07975 Louisiana

Profile Details

NPI number 1023417722
LBN Legal business name Boudreaux, Misty
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2014
Last updated Nov 18th, 2014 - about 12 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 1023417722 NPPES
Mississippi MEDICAID 07984823
Mississippi MEDICAID 2373234

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