Individual
TY ANTHONY GAUTREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
12525 PERKINS RD, BATON ROUGE, LA 70810-1907
(225) 819-8857
(225) 767-6822
Mailing address
2762 CONTINENTAL DR, STE 201, BATON ROUGE, LA 70808-3240
(225) 706-3033
(225) 218-4888
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04859
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034789
—
LA
Enumeration date
02/15/2008
Last updated
06/30/2016
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