Individual
MICHAEL J. LATIOLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4212 W CONGRESS ST, SUITE 3200, LAFAYETTE, LA 70506-6765
(337) 981-3546
Mailing address
PO BOX 60475, LAFAYETTE, LA 70596-0475
(337) 981-0305
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP04850
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1369331
—
LA
Enumeration date
09/21/2006
Last updated
07/08/2007
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