Individual
CLAIRE ROETHELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 RUE DE LA VIE ST STE 405, BATON ROUGE, LA 70817-5128
(225) 928-2555
(225) 929-9685
Mailing address
PO BOX 45171, BATON ROUGE, LA 70895-4171
(225) 928-2555
(225) 929-9685
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
323733
LA
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
323733
LICENSE
LA
Enumeration date
07/20/2020
Last updated
05/26/2021
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