Provider Demographics
NPI:1851574909
Name:BADEAUX, CATHERINE P (CNM)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:P
Last Name:BADEAUX
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 PICARDY AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3670
Mailing Address - Country:US
Mailing Address - Phone:225-763-4990
Mailing Address - Fax:225-763-4981
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3670
Practice Address - Country:US
Practice Address - Phone:225-763-4990
Practice Address - Fax:225-763-4981
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN058473/AP04008367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1121860Medicaid