MEDICARE: BROOKE ANN EMFINGER PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1275152647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ANN EMFINGER PA

Provider Business Mailing Address
First Line	:	1103 KALISTE SALOOM RD
Second Line	:	STE 100
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-5784
Country	:	US
Telephone Number	:	337-303-8082
Fax Number	:

Provider Business Practice Location Address
First Line	:	836 S CLEARVIEW PKWY APT 256
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70123-6340
Country	:	US
Telephone Number	:	337-303-8082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	04/26/2021

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Directions to “ BROOKE ANN EMFINGER PA” Practice Location

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