Individual
DEIRDRE IRENE DETRAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANPC
Contact information
Practice address
207 N LUKE ST, LAFAYETTE, LA 70506
(337) 739-7278
(337) 419-0533
Mailing address
PO BOX 81095, LAFAYETTE, LA 70598-1095
(337) 739-7278
(337) 989-7036
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APO 4805
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031224
—
LA
Enumeration date
07/14/2006
Last updated
11/08/2024
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