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Individual

MS. DONNA LOUISE BOURQUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
801 W BAYOU PINES DR, LAKE CHARLES, LA 70601-7076
(337) 439-3205
(337) 439-0807
Mailing address
280 QUARTER HORSE LN, SINGER, LA 70660-3546
(337) 786-3245
(337) 786-3245

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
78482
LA

Other

Enumeration date
05/03/2007
Last updated
07/08/2007
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