Individual
LATICIA CHEMEARE BEAUDOIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 E VAUGHN AVE, RUSTON, LA 71270-5950
(318) 254-2100
(318) 254-2728
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1015504
TX
363L00000X
Nurse Practitioner
PENDING
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1O8931
MEDICARE
TX
Enumeration date
10/02/2020
Last updated
06/23/2021
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