Individual
WENDY CHAMPAGNE FUSELIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1525 E BRIDGE ST, BREAUX BRIDGE, LA 70517-3401
(337) 442-1131
Mailing address
206 CHAMPAGNE BLVD, SUITE A, BREAUX BRIDGE, LA 70517-3734
(337) 332-3500
(337) 332-3200
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.A10410RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C542PA79
PA PTAN
LA
Enumeration date
12/01/2008
Last updated
03/06/2024
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