Individual
STACEY SMITH PERRAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
5339 DIDESSE DR, BATON ROUGE, LA 70808-4306
(225) 765-3076
(225) 765-3090
Mailing address
5339 DIDESSE DR, BATON ROUGE, LA 70808-4306
(225) 765-3076
(225) 765-3090
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04588
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1478831
—
LA
01
—
P00251944
RAILROAD MEDICARE
LA
Enumeration date
12/05/2005
Last updated
12/03/2007
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