Basic Information
Provider Information
NPI: 1104051895
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HEMSELL
FirstName: ERIN
MiddleName: BOUILLION
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4640 AMBASSADOR CAFFERY PKWY
Address2:  
City: LAFAYETTE
State: LA
PostalCode: 705086902
CountryCode: US
TelephoneNumber: 3379841050
FaxNumber: 3379848776
Practice Location
Address1: 4640 AMBASSADOR CAFFERY PKWY
Address2:  
City: LAFAYETTE
State: LA
PostalCode: 705086902
CountryCode: US
TelephoneNumber: 3379841050
FaxNumber: 3379848776
Other Information
ProviderEnumerationDate: 05/25/2009
LastUpdateDate: 07/19/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207V00000X206368LAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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