Provider Demographics
NPI:1891289302
Name:BAUDOIN-WILLEM, HALEY BROOKE (DMSC, PA-C)
Entity Type:Individual
Prefix:DR
First Name:HALEY
Middle Name:BROOKE
Last Name:BAUDOIN-WILLEM
Suffix:
Gender:F
Credentials:DMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 WOODWARD AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-4323
Mailing Address - Country:US
Mailing Address - Phone:337-523-1645
Mailing Address - Fax:240-690-5118
Practice Address - Street 1:3001 DIVISION ST STE 100
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5855
Practice Address - Country:US
Practice Address - Phone:337-523-1645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA308904OtherSTATE LICENCE