Provider Demographics
NPI:1841696960
Name:DUGAS, AMANDA KAYE (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAYE
Last Name:DUGAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 4176
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-4176
Mailing Address - Country:US
Mailing Address - Phone:985-872-5864
Mailing Address - Fax:985-872-0317
Practice Address - Street 1:500 N LEWIS ST
Practice Address - Street 2:STE. 100
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2046
Practice Address - Country:US
Practice Address - Phone:337-367-5200
Practice Address - Fax:337-369-3074
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2381164Medicaid
LA2381164Medicaid