MEDICARE: MRS. KRISTI C PREJEANT M.D.

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
1	146D00000X	Personal Emergency Response Attendant	23462	OK
2	208600000X	Surgery Physician	MD.204181	LA

General Provider Information

NPI Number	:	1396758652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTI C PREJEANT M.D.

Provider Business Mailing Address
First Line	:	1302 LAKEWOOD DR.
Second Line	:	SUITE 202
City	:	MORGAN CITY
State	:	LA
Zip	:	70380
Country	:	US
Telephone Number	:	985-384-3433
Fax Number	:	985-384-3453

Provider Business Practice Location Address
First Line	:	1302 LAKEWOOD DR.
Second Line	:	SUITE 202
City	:	MORGAN CITY
State	:	LA
Zip	:	70380
Country	:	US
Telephone Number	:	985-384-3433
Fax Number	:	985-384-3453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	02/13/2012

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Directions to “ MRS. KRISTI C PREJEANT M.D.” Practice Location

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