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Individual

KIMBERLY ANN CHASTANT-POCHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPAS, PA-C

Contact information

Practice address
4200 HOUMA BLVD, METAIRIE, LA 70006-2970
(504) 503-6792
Mailing address
4200 HOUMA BLVD, METAIRIE, LA 70006-2970
(504) 503-6792

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.200047RX
LA
363AS0400X
Surgical Physician Assistant
PA.200047RX
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01227833
MS
05
1001759
LA
Enumeration date
12/06/2006
Last updated
07/08/2014
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