Individual
BRIANKEITH BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 LINE AVE, SHREVEPORT, LA 71101-4612
(318) 677-3139
Mailing address
712 MELANCON ST, OPELOUSAS, LA 70570-7964
(337) 308-6219
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
211069
LA
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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