1710280631 NPI number — MRS. ALEXSIS WHITE LANGLOIS RN, BSN, CRNA

Table of content: MRS. ALEXSIS WHITE LANGLOIS RN, BSN, CRNA (NPI 1710280631)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710280631 NPI number — MRS. ALEXSIS WHITE LANGLOIS RN, BSN, CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE LANGLOIS
Provider First Name:
ALEXSIS
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, BSN, CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITE
Provider Other First Name:
ALEXSIS
Provider Other Middle Name:
ADAIRE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN, CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1710280631
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39509 MADISON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRAIRIEVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70769-4987
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-622-3904
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
39509 MADISON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRAIRIEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70769-4987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-622-3904
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  109942 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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