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NPI Code Detail

MEDICARE: MR. STEPHEN KIRK BILLEAUDEAUX R.N.

MEDICARE: MR. STEPHEN KIRK BILLEAUDEAUX R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN117188LA

General Provider Information

NPI Number : 1245618651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN KIRK BILLEAUDEAUX R.N.
Provider Business Mailing Address
First Line : 19520 PATTERSON RD
Second Line :
City : WELSH
State : LA
Zip : 70591-6516
Country : US
Telephone Number : 337-540-0638
Fax Number :
Provider Business Practice Location Address
First Line : 106 W PORT ST
Second Line :
City : DERIDDER
State : LA
Zip : 70634-4040
Country : US
Telephone Number : 337-462-1461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2015
Last Update Date : 05/18/2015

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Directions to “ MR. STEPHEN KIRK BILLEAUDEAUX R.N.” Practice Location

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