Healthcare Provider Details

I. General information

NPI: 1093171951
Provider Name (Legal Business Name): CRNA OF BATON ROUGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2016
Last Update Date: 01/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7855 HOWELL BLVD
BATON ROUGE LA
70807-5256
US

IV. Provider business mailing address

5710 LBJ FWY STE 300
DALLAS TX
75240-6324
US

V. Phone/Fax

Practice location:
  • Phone: 225-228-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA HAWKINS
Title or Position: BILLING MANAGER
Credential:
Phone: 214-888-8108