Healthcare Provider Details

I. General information

NPI: 1598524480
Provider Name (Legal Business Name): MEGHAN HEBERT BARDWELL MSN-CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 RUE DE LA VIE ST
BATON ROUGE LA
70817-5133
US

IV. Provider business mailing address

10656 CREEK HAVEN LANE
DENHAM SPRINGS LA
70726
US

V. Phone/Fax

Practice location:
  • Phone: 225-761-1200
  • Fax: 225-761-1215
Mailing address:
  • Phone: 225-270-1662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM08139
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: