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General NPI Number Information
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NPI Number | 1922276740
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Entity Type | Individual
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Provider Name | PETER BRIAN CRAPANZANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | BEACON HEALING & WELLNESS, LLC 671 RIVER HIGHLANDS BLVD., SUITE 8
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City | COVINGTON
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State | LA
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Zip | 70433
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Country | US
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Telephone | 985-624-2942
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Fax | 985-888-1120
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Provider Business Mailing Address
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Address Line | 8901 CHRETIEN POINT PL
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City | RIVER RIDGE
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State | LA
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Zip | 70123-2714
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD.09780R
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License Number State | LA
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