Organization
DAUTERIVE PROFESSIONALS MANAGEMENT
Active
Other names
LST ANESTHESIA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE BOUDREAUX (CFO)
(337) 365-2812
Entity
Organization
Contact information
Practice address
600 N LEWIS ST, NEW IBERIA, LA 70563-2043
(337) 365-3168
Mailing address
PO BOX 53533, LAFAYETTE, LA 70505-3533
(337) 365-3168
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447030
—
LA
Enumeration date
07/11/2006
Last updated
03/28/2008
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