Individual
JENNIFER EILEEN BADEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1415 TULANE AVE, NEW ORLEANS, LA 70112-2600
(504) 988-5903
Mailing address
102 OAK ALLEY, MANDEVILLE, LA 70471-3062
(512) 296-5589
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
630433
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP04468
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1775033-01
—
TX
01
—
85903U
BLUE SHIELD
TX
Enumeration date
04/07/2006
Last updated
06/17/2010
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