Provider Demographics
NPI:1932076338
Name:ENDRIS, CLAIRE ELISE
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELISE
Last Name:ENDRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HIGHWAY 71 84
Mailing Address - Street 2:
Mailing Address - City:COUSHATTA
Mailing Address - State:LA
Mailing Address - Zip Code:71019-4158
Mailing Address - Country:US
Mailing Address - Phone:318-471-7515
Mailing Address - Fax:
Practice Address - Street 1:102 HIGHWAY 71 84
Practice Address - Street 2:
Practice Address - City:COUSHATTA
Practice Address - State:LA
Practice Address - Zip Code:71019-4158
Practice Address - Country:US
Practice Address - Phone:318-471-7515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program