Healthcare Provider Details

I. General information

NPI: 1649936956
Provider Name (Legal Business Name): STEPHANIE C BADON APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E MAIN ST STE 101
NEW IBERIA LA
70560-3725
US

IV. Provider business mailing address

124 E MAIN ST STE 101
NEW IBERIA LA
70560-3725
US

V. Phone/Fax

Practice location:
  • Phone: 337-606-3988
  • Fax: 800-867-6270
Mailing address:
  • Phone: 337-606-3988
  • Fax: 800-867-6270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number221995
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number221995
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: