Basic Information
| Provider Information | |||||||||
| NPI: | 1538401666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIENVENU-OUBRE | ||||||||
| FirstName: | SHAUNA | ||||||||
| MiddleName: | RAYE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2419 ALONZO ST | ||||||||
| Address2: | |||||||||
| City: | ABBEVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705104008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3378920630 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1402 W 8TH ST | ||||||||
| Address2: | |||||||||
| City: | KAPLAN | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705482918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372856033 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2013 | ||||||||
| LastUpdateDate: | 01/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | MD.207438 | LA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.