Basic Information
| Provider Information | |||||||||
| NPI: | 1538183108 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARBONEAUX | ||||||||
| FirstName: | BENJI | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9655 PERKINS RD | ||||||||
| Address2: | STE C | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708101534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372898970 | ||||||||
| FaxNumber: | 3372898971 | ||||||||
| Practice Location | |||||||||
| Address1: | 9655 PERKINS RD | ||||||||
| Address2: | STE C | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708101534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2253870851 | ||||||||
| FaxNumber: | 2253838477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 08/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP04911 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 1712507 | 05 | LA | MEDICAID | P00346374 | 01 | RAILROAD MEDICARE | OTHER |