Provider Demographics
NPI:1174273627
Name:DUFRENE, MICHELLE H
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:H
Last Name:DUFRENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-2818
Mailing Address - Country:US
Mailing Address - Phone:985-209-7549
Mailing Address - Fax:
Practice Address - Street 1:649 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-2818
Practice Address - Country:US
Practice Address - Phone:985-209-7549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA224376363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily