MRS. BRANDI RENE BOUTTE


Address: 1101 Kaliste Saloom Rd Ste 304, Lafayette, LA 70508-5705
Phone: 3379885646

MRS. BRANDI RENE BOUTTE (NPI# 1003371840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003371840
Entity Type Individual
Full Name MRS. BRANDI RENE BOUTTE
Credential FNP-C
Practice Address 1101 Kaliste Saloom Rd Ste 304
Lafayette
LA 70508-5705
Practice Telephone 3379885646
Practice Fax Number 3377690031
Mailing Telephone 3379885646
Mailing Fax Number 3377960031
Enumeration Date 2019-02-06
Last Update Date 2019-02-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
203614 LA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1101 KALISTE SALOOM RD STE 304
City LAFAYETTE
State LA
Zip Code 70508-5705

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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1477117562 Kayley Jon Myers Nurse Practitioner 200 Beaullieu Dr Ste 6, Lafayette, LA 70508-7230 2019-04-24
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Competitor

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City LAFAYETTE
Zip Code 70508

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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