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Individual

AMANDA BUCHER KWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
8595 PICARDY AVE STE 235, BATON ROUGE, LA 70809-0610
(225) 381-2615
Mailing address
8595 PICARDY AVE STE 235, BATON ROUGE, LA 70809-0610
(225) 381-2615
(225) 381-2638

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009077500
DRIVERS LICENSE NUMBER
LA
05
2420739
LA
01
302198
PA LICENSE
LA
Enumeration date
04/28/2016
Last updated
11/02/2021
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