Provider Demographics
NPI:1720447923
Name:DUPLANTIS, GINGER (CST,CSFA)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:DUPLANTIS
Suffix:
Gender:F
Credentials:CST,CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 THEALL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-9259
Mailing Address - Country:US
Mailing Address - Phone:912-844-7513
Mailing Address - Fax:912-335-5032
Practice Address - Street 1:917 COOLIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2433
Practice Address - Country:US
Practice Address - Phone:912-844-7513
Practice Address - Fax:912-335-5032
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA163882246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant