Provider Demographics
NPI:1205192754
Name:GAUTREAUX, JANA B (APRN)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:B
Last Name:GAUTREAUX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-5430
Mailing Address - Country:US
Mailing Address - Phone:225-333-9559
Mailing Address - Fax:808-222-3230
Practice Address - Street 1:101 JACKSON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-5430
Practice Address - Country:US
Practice Address - Phone:225-333-9559
Practice Address - Fax:808-222-3230
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06792363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health