Provider Demographics
NPI:1437264785
Name:GUITEAU-LAURENT, ANGELIQUE D (NP)
Entity Type:Individual
Prefix:MS
First Name:ANGELIQUE
Middle Name:D
Last Name:GUITEAU-LAURENT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ANGELIQUE
Other - Middle Name:D
Other - Last Name:COZIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:7968 ESSEN PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-761-3400
Mailing Address - Fax:225-761-3507
Practice Address - Street 1:7968 ESSEN PARK AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-7439
Practice Address - Country:US
Practice Address - Phone:225-761-3400
Practice Address - Fax:225-761-3507
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1111210Medicaid
LA3B812DE56Medicare PIN
LA1111210Medicaid