Healthcare Provider Details

I. General information

NPI: 1699682641
Provider Name (Legal Business Name): CAMERON HASSENBOEHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 LOUISVILLE AVE
MONROE LA
71201-6685
US

IV. Provider business mailing address

532 BELLANGER ST
HARVEY LA
70058-2746
US

V. Phone/Fax

Practice location:
  • Phone: 318-718-9948
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: