Basic Information
Provider Information
NPI: 1609810712
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERRIGAN
FirstName: DONALD
MiddleName: PATRICK
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9103 JEFFERSON HWY
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708092440
CountryCode: US
TelephoneNumber: 2259271190
FaxNumber: 2257060160
Practice Location
Address1: 9103 JEFFERSON HWY
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708092440
CountryCode: US
TelephoneNumber: 2259271190
FaxNumber: 2257060160
Other Information
ProviderEnumerationDate: 06/16/2006
LastUpdateDate: 11/26/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN041089LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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