Diane Marie Badeaux, APRN, NP,CNS, BC

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Galliano, LA

NPI 1003961830 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1003961830
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
RN033751-AP02182 (LA)
Practice address
127 East 123 Rd Street
Galliano, LA 70354
Phone
(985) 632-2175
Fax
(985) 632-8651
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN033751-AP02182LAMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN033751-AP02182 LA Yes

Addresses

Primary practice location

127 East 123 Rd Street
Galliano, LA 70354

Mailing address

420 Hwy 653
Raceland, LA 70394
Phone (985) 537-6675

Other identifiers

IdentifierTypeStateIssuer
1435091MedicaidLA

Other providers in Galliano, LA

All providers in Galliano, LA · Psychiatric/Mental Health Nurse Practitioner in Louisiana

Sources for this page

Verify at the official NPI Registry.