Individual
EDEN DESIREE ETCHEVERRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 355-2332
Mailing address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 355-2332
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
307132
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2457185
—
LA
Enumeration date
09/05/2017
Last updated
07/21/2022
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