DEIRDRE IRENE DETRAZ (NPI# 1396761060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396761060 |
| Entity Type | Individual |
| Full Name | DEIRDRE IRENE DETRAZ |
| Credential | ANP-C |
| Practice Address |
2801 Kaliste Saloom Rd Suite 200 B Lafayette LA 70508-7181 |
| Mailing Address |
Po Box 81095 Lafayette LA 70598-1095 |
| Practice Telephone | 3377397278 |
| Practice Fax Number | 3379897036 |
| Mailing Telephone | 3377397278 |
| Mailing Fax Number | 3379897036 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2012-11-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APO 4805 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1031224 | 05 |
| Street Address |
2801 KALISTE SALOOM RD SUITE 200 B |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-7181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588917603 | Apex Prevention, LLC | Nurse Practitioner | 2801 Kaliste Saloom Rd, Suite 200b, Lafayette, LA 70508-7181 | 2012-10-26 |
| 1871627547 | Dr Suzanne P Dardeau A Community Chiropractic Corp | Chiropractor | 2801 Kaliste Saloom Rd, Suite 200, Lafayette, LA 70508-7181 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285182550 | Elizabeth Anne Summerhayes | Nurse Practitioner | 3542 Oconner Dr, Lafayette, CA 94549-4933 | 2016-09-15 |
| 1194106674 | Jessica J. Meredith | Nurse Practitioner | 4118 Trees Dr, Lafayette, IN 47909-3450 | 2015-06-10 |
| 1013291350 | Shelly Sebastien Richard | Nurse Practitioner | 501 W Saint Mary Blvd Ste 200, Lafayette, LA 70506-4665 | 2011-10-05 |
| 1134442692 | Christine Devillier Richard | Nurse Practitioner | 522 Harrell Dr, Lafayette, LA 70503-4935 | 2010-03-11 |
| 1679761761 | Grace Ihsiu Todd | Nurse Practitioner | 964 Mezzanine Dr, Planned Parenthood of Indiana and Kentucky, Lafayette, IN 47905-8631 | 2007-10-15 |
| 1861451106 | Anne Elizabeth Zahnke | Nurse Practitioner | 1 W 240 S, Lafayette, IN 47909-6303 | 2006-03-23 |
| 1194728568 | Gilbert Almanza | Nurse Practitioner | 1345 Unity Pl, Suite 345, Lafayette, IN 47905-5760 | 2005-05-31 |
| 1891330726 | Sarah Roth | Nurse Practitioner | 3750 Landmark Dr Ste B, Lafayette, IN 47905-6652 | 2019-11-14 |
| 1235774431 | Rdd Consulting | Nurse Practitioner | 3400 Moss St Ste B, Lafayette, LA 70507-6114 | 2019-11-12 |
| 1275176547 | Nadia Marie Oquendo | Nurse Practitioner | 1205 N 14th St, Lafayette, IN 47904-2024 | 2019-10-19 |
| Find all providers in LAFAYETTE | ||||
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| 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.