Healthcare Provider Details

I. General information

NPI: 1164159208
Provider Name (Legal Business Name): ALEXANDRA KATHRYN BRELAND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 N CAUSEWAY BLVD STE 8
MANDEVILLE LA
70471-8602
US

IV. Provider business mailing address

1814 N CAUSEWAY BLVD STE 8
MANDEVILLE LA
70471-8602
US

V. Phone/Fax

Practice location:
  • Phone: 985-317-7442
  • Fax: 985-202-8238
Mailing address:
  • Phone: 985-317-7442
  • Fax: 985-202-8238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226841
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number226841
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: