Provider Demographics
NPI:1326589508
Name:BOUDREAUX, BRITTANY LYNN (DO)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNN
Last Name:BOUDREAUX
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 UTICA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-6579
Mailing Address - Country:US
Mailing Address - Phone:504-457-3687
Mailing Address - Fax:504-620-0250
Practice Address - Street 1:4409 UTICA ST STE 100
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-6579
Practice Address - Country:US
Practice Address - Phone:504-457-3687
Practice Address - Fax:504-620-0250
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA320001207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine