Individual
BROOKE MARIE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 MEDICAL CENTER BLVD., SUITE S-450, MARRERO, LA 70072-3151
(504) 349-6401
(504) 349-6444
Mailing address
PO BOX 1520, MARRERO, LA 70073
(504) 349-6423
(504) 934-8097
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.200783
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2381130
—
LA
Enumeration date
01/09/2015
Last updated
07/02/2015
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