Individual
MICHAEL RHETT DUPUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
801 POINCIANA AVE, MAMOU, LA 70554-2243
(337) 468-0152
(337) 468-0451
Mailing address
1353 OBERLIN RD, MAMOU, LA 70554-4210
(337) 468-5888
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN039651
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1398853
—
LA
01
—
298775ZJR7
MEDICARE PTAN
LA
Enumeration date
05/01/2006
Last updated
02/24/2017
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