| Mrs Brandi Boudreaux Payne, FNP-C | |
|
827 N Pine St, Gramercy, LA 70052-3602 | |
| (225) 869-9200 | |
| (225) 869-9241 |
| Full Name | Mrs Brandi Boudreaux Payne |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 827 N Pine St, Gramercy, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336573492 | NPI | - | NPPES |
| 2346806 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | AP07475 (Louisiana) | Primary |
| Entity Name | Baton Rouge General Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992729560 PECOS PAC ID: 5193623643 Enrollment ID: O20080611000068 |
| Entity Name | Louisiana Internal Medicine Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548772957 PECOS PAC ID: 7719245695 Enrollment ID: O20171226000250 |
| Entity Name | Specialty Infusion Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750933230 PECOS PAC ID: 9931532116 Enrollment ID: O20191202000603 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Brandi Boudreaux Payne, FNP-C 2122 South Richland Ave, Gonzales, LA 70737-4057 Ph: (225) 324-1645 | Mrs Brandi Boudreaux Payne, FNP-C 827 N Pine St, Gramercy, LA 70052-3602 Ph: (225) 869-9200 |
Chad M Madere, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 827 N Pine St, Gramercy, LA 70052 Phone: 225-869-9200 Fax: 225-869-9241 | |
Holly Martin Millet, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 827 N Pine St, Gramercy, LA 70052 Phone: 225-869-9200 Fax: 225-869-9241 | |
Shanedolyn Grover, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 827 N Pine St, Gramercy, LA 70052 Phone: 225-869-9200 Fax: 225-869-9241 |