Individual
MRS. MAREESA PERRAULT MATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2730 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5939
(337) 988-1585
(337) 981-4694
Mailing address
2390 W CONGRESS ST, ONCOLOGY DEPARTMENT, 5NORTH, LAFAYETTE, LA 70506-4205
(337) 261-6515
(337) 261-6555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
06624
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2190261
—
LA
Enumeration date
10/04/2011
Last updated
11/18/2013
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