Healthcare Provider Details

I. General information

NPI: 1477815397
Provider Name (Legal Business Name): ANNE F GASPARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W WILLOW ST BLDG A
LAFAYETTE LA
70501-2837
US

IV. Provider business mailing address

220 W WILLOW ST BLDG A
LAFAYETTE LA
70501-2837
US

V. Phone/Fax

Practice location:
  • Phone: 337-262-5616
  • Fax: 337-262-1310
Mailing address:
  • Phone: 337-262-5616
  • Fax: 337-262-1310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN028313
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: