Provider Demographics
NPI:1689711848
Name:AUGUILLARD, EVA L (LPN)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:L
Last Name:AUGUILLARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 GALLIAN ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6425
Mailing Address - Country:US
Mailing Address - Phone:337-654-1129
Mailing Address - Fax:
Practice Address - Street 1:302 DULLES DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3008
Practice Address - Country:US
Practice Address - Phone:337-262-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA860343164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse