Healthcare Provider Details

I. General information

NPI: 1487205076
Provider Name (Legal Business Name): JANELLE BOYDSTUN TRICHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANELLE BOYDSTUN TRICHELL

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 JENNIFERS PL
PINEVILLE LA
71360-2750
US

IV. Provider business mailing address

1039 JENNIFERS PL
PINEVILLE LA
71360-2750
US

V. Phone/Fax

Practice location:
  • Phone: 318-290-9188
  • Fax:
Mailing address:
  • Phone: 318-290-9188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: