Individual
CODY JAMES PREJEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
413 CAVANESS DR, HOUMA, LA 70364-2221
(985) 859-6323
Mailing address
PO BOX 6014, HOUMA, LA 70361-6014
(985) 850-6398
(985) 873-3789
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
220291
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220291
LICENSE
LA
Enumeration date
03/23/2020
Last updated
06/04/2021
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