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Individual

MS. STACEY GREEN PRATHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
108 RUE LOUIS XIV, LAFAYETTE, LA 70508-5739
(337) 235-8007
(337) 235-8008
Mailing address
108 RUE LOUIS XIV, LAFAYETTE, LA 70508-5739
(337) 889-3074
(337) 889-3112

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
200502
LA
363A00000X
Physician Assistant
Primary
PA200502
LA

Other

Enumeration date
09/24/2011
Last updated
06/15/2023
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