Individual
MRS. BRANDI RENE BOUTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
220 HEBRARD BLVD, LAFAYETTE, LA 70504
(337) 482-1293
(337) 482-6428
Mailing address
1101 KALISTE SALOOM RD STE 304, LAFAYETTE, LA 70508-5705
(337) 988-5646
(337) 796-0031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
203614
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2490681
—
LA
Enumeration date
02/06/2019
Last updated
12/16/2025
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