Individual
MS. DANA DOSHER DEGRAVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7301 HENNESSY BLVD, SUITE 200, BATON ROUGE, LA 70808
(225) 266-0050
(225) 766-1499
Mailing address
P.O. BOX 98035, BATON ROUGE, LA 70898-9035
(225) 766-0050
(225) 766-1499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10393.RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1779024
—
LA
Enumeration date
07/20/2006
Last updated
08/06/2008
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