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Individual

MS. CHRISTINE BOUTTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2804 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5906
(337) 981-5156
(337) 981-0673
Mailing address
2804 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5906
(337) 981-5156
(337) 981-0673

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
101637-7753
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1992747349
NPI
LA
Enumeration date
06/24/2014
Last updated
06/24/2014
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