Healthcare Provider Details

I. General information

NPI: 1952578965
Provider Name (Legal Business Name): JANICE B PFISTER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8212 SUMMA AVE
BATON ROUGE LA
70809-3421
US

IV. Provider business mailing address

100 WOMANS WAY
BATON ROUGE LA
70817-5100
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-4403
  • Fax: 225-769-3842
Mailing address:
  • Phone: 225-293-2523
  • Fax: 225-293-1807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN059869 AP05382
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: