# ALEXIS BOURGEOIS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356007637
- **Authorized official:** MRS. ALEXIS BOURGEOIS NP (OWNER-PRESIDENT)
- **Authorized official phone:** (337) 889-3682

## Contact information

- **Practice address:** 605 S LEWIS ST, NEW IBERIA, LA 70560-4820
- **Practice address phone:** (337) 889-3682
- **Practice address fax:** (337) 806-9339
- **Mailing address:** 215 RUE FONTAINE, LAFAYETTE, LA 70508-5742
- **Mailing address phone:** (337) 889-3682
- **Mailing address fax:** (337) 806-9339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/11/2021
- **Last updated:** 11/11/2021