Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP09805 | LA |
NPI | 1033618772 |
---|---|
Provider Name | Mrs. Blaire Weatherford Arceneaux |
First Address | Denham Springs, LA 70726-3524 |
Second Address | New Orleans, LA 70118-5720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2018 |
Last Update Date | 17/03/2018 |