Individual
MRS. BRITTANY D BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 DOLHONDE ST, GRETNA, LA 70053-5801
(504) 374-7768
Mailing address
4708 CHASTANT ST, METAIRIE, LA 70006-2060
(504) 813-4177
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.200280
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02154365
—
MS
05
—
2315633
—
LA
Enumeration date
02/14/2011
Last updated
10/15/2013
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