Provider Demographics
NPI:1528567849
Name:BAJON, MICHELLE B (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:B
Last Name:BAJON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2644 S SHERWOOD FOREST BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2248
Mailing Address - Country:US
Mailing Address - Phone:225-293-2523
Mailing Address - Fax:225-293-1807
Practice Address - Street 1:100 WOMANS WAY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-5100
Practice Address - Country:US
Practice Address - Phone:225-924-8149
Practice Address - Fax:225-293-1807
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09707207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology