Individual provider · Type 1 NPI

Raegen Harbour Boudreaux, PA

Surgical Physician Assistant · New Orleans, LA

NPI number 1952883605 Active

Practice location

1717 Saint Charles Ave
New Orleans, LA 70130-5223

Mailing address

5262 Woodside Dr
Baton Rouge, LA 70808-1951

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X310483 (LA)

Surgical Physician Assistant: Definition to come...

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About NPI 1952883605

Raegen Harbour Boudreaux, PA's National Provider Identifier is 1952883605, issued on Aug 29, 2018. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in New Orleans, LA. The record was last updated on Jul 7, 2022.