Individual
ANDREE CELESTE BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF MEDICINE, SHREVEPORT, LA 71103-4228
(318) 813-2528
(318) 813-2565
Mailing address
1501 KINGS HWY, DEPARTMENT OF MEDICINE, SHREVEPORT, LA 71103-4228
(318) 813-2528
(318) 813-2565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10306
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1626392
—
LA
Enumeration date
07/20/2006
Last updated
09/03/2010
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