Provider Demographics
NPI:1497189088
Name:GAGNARD, YENEY (PA)
Entity type:Individual
Prefix:MRS
First Name:YENEY
Middle Name:
Last Name:GAGNARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53069
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505
Mailing Address - Country:US
Mailing Address - Phone:954-442-8380
Mailing Address - Fax:954-442-8661
Practice Address - Street 1:501 W. ST. MARY BLVD
Practice Address - Street 2:STE. 110
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506
Practice Address - Country:US
Practice Address - Phone:337-233-8887
Practice Address - Fax:337-233-4442
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAT9107417363A00000X
LA305875363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant