Individual
BRIAN JAMES CREDEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8246
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 433-8400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07219
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2327241
—
LA
Enumeration date
02/20/2013
Last updated
07/03/2013
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