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Individual

JOHANNA BOURGEOIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
715B WELDON ST, NEW IBERIA, LA 70560-4861
(337) 373-0021
Mailing address
11708 OLD JEANERETTE RD, JEANERETTE, LA 70544-5922

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN043756
LA

Other

Enumeration date
06/15/2012
Last updated
06/15/2012
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