Individual
LISA BOUDREAUX ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4141 N UNIVERSITY AVE, CARENCRO, LA 70520-4204
(337) 565-2692
(337) 565-2704
Mailing address
401 YOUNGSVILLE HWY, SUITE 100, LAFAYETTE, LA 70508-5173
(337) 330-0031
(337) 330-0059
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP07493
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2343289
—
LA
Enumeration date
08/19/2013
Last updated
09/13/2016
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