Individual
MR. MATTHEW J GAUTREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8212 SUMMA AVE, BATON ROUGE, LA 70809-3421
(225) 769-4403
(225) 769-3842
Mailing address
8212 SUMMA AVE, BATON ROUGE, LA 70809-3421
(225) 769-4403
(225) 769-3842
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP04380
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP04380
ADVANCED PRACTICE LIC
LA
Enumeration date
10/04/2006
Last updated
07/08/2007
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