Individual
DONNA JEANNE VIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1245 CAMELLIA BLVD STE 300, LAFAYETTE, LA 70508-7219
(337) 839-2773
Mailing address
6411 PERKINS RD STE 100, BATON ROUGE, LA 70808-4125
(225) 303-9500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000001234
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.A10442
MEDICAL LICENSE
LA
Enumeration date
07/06/2006
Last updated
06/25/2019
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