Provider Demographics
NPI:1205670478
Name:BREAUX, CHRISTINA (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BREAUX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42447 GREENS VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-8589
Mailing Address - Country:US
Mailing Address - Phone:985-237-9219
Mailing Address - Fax:
Practice Address - Street 1:9730 BLUEBONNET BLVD STE 6
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2749
Practice Address - Country:US
Practice Address - Phone:225-250-5262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-22
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist