Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD208228 | LA |
NPI | 1093134256 |
---|---|
Provider Name | Brittani Mcclain Breaux |
First Address | Baton Rouge, LA 70817-5129 |
Second Address | Baton Rouge, LA 70817-5129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2492292 | (05) | LA |