Healthcare Provider Details

I. General information

NPI: 1407859945
Provider Name (Legal Business Name): EMILY BORISKIE GRASER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2005
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 HELLEN ST
LAFAYETTE LA
70501-3468
US

IV. Provider business mailing address

720 GIRARD PARK DR
LAFAYETTE LA
70503-2806
US

V. Phone/Fax

Practice location:
  • Phone: 337-231-0035
  • Fax: 337-261-4068
Mailing address:
  • Phone: 337-231-0035
  • Fax: 337-261-4068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN22865 APO1927
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: