EDIE B POURCIAU (NPI# 1659557940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659557940 |
| Entity Type | Individual |
| Full Name | EDIE B POURCIAU |
| Other Name | EDIE B BOUDREAUX |
| Credential | NP |
| Practice Address |
124 E Main St Ste. 104 New Iberia LA 70560 |
| Mailing Address |
Po Box 9227 New Iberia LA 70562-9227 |
| Practice Telephone | 3376089922 |
| Practice Fax Number | 3376089933 |
| Mailing Telephone | 3376089922 |
| Mailing Fax Number | 3376089933 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2019-07-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP05466 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP05466 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | AETNA | 2515256 | 01 |
| LA | CAQH | 11849024 | 01 |
| LA | 1309877 | 05 |
| Street Address |
124 E MAIN ST STE. 104 |
| City | NEW IBERIA |
| State | LA |
| Zip Code | 70560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306197538 | Acadian Homecare of New Iberia, LLC | Home Health | 124 E Main St, Suite 210, New Iberia, LA 70560-3725 | 2012-09-27 |
| 1588835185 | Michael Sinclair Blue | Psychiatry & Neurology | 124 E Main St, Suite 106, New Iberia, LA 70560-3725 | 2008-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578289 | Kelly Koch | Speech-Language Pathologist | 3919 Highway 14, New Iberia, LA 70560 | 2020-01-30 |
| 1043791262 | Mark Gray | Case Manager/Care Coordinator | 4601 E Admiral Doyle Dr, New Iberia, LA 70560 | 2018-08-25 |
| 1215418512 | Jada Renee Delahoussaye | Case Manager/Care Coordinator | 324 Copper Rd, New Iberia, LA 70560 | 2018-08-24 |
| 1639665334 | Sarah D. Lalande | Audiologist | 2308 E Main St Ste B, New Iberia, LA 70560 | 2018-07-05 |
| 1447766142 | Kirston Gardner | Counselor | 902 Jefferson Ter Ste D, New Iberia, LA 70560 | 2017-12-18 |
| 1902334048 | Keithlyn James | Counselor | 902 Jefferson Ter Ste E, New Iberia, LA 70560 | 2017-06-02 |
| 1619424926 | Dialysis Clinic Inc | Clinic/Center | 2708 E. Main St, New Iberia, LA 70560 | 2016-09-02 |
| 1720433477 | Theresa Armstead | Counselor | 1614 East Main St., Ste D, 36o Mental Health, LLC, New Iberia, LA 70560 | 2016-05-02 |
| 1033564711 | Johonnah Metzel | Case Manager/Care Coordinator | 209 W Main St Ste 200, New Iberia, LA 70560 | 2016-04-29 |
| 1508241969 | Sworoop Thomas John | Internal Medicine | 2315 East Main Street, Medical Staff Office, New Iberia, LA 70560 | 2015-07-28 |
| Find all providers in zip 70560 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003146101 | Jonathan A Seghorn | Nurse Practitioner | 806 Jefferson Ter, New Iberia, LA 70560 | 2010-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972113124 | Rebirth Mental Health Services LLC | Nurse Practitioner | 2116 Gause Blvd W Ste E, Slidell, LA 70460-4120 | 2020-08-03 |
| 1427668748 | Julie Susann Dyrek | Nurse Practitioner | 1 Lakeshore Dr Ste 1830, Lake Charles, LA 70629-0114 | 2020-08-01 |
| 1376169979 | Nancy Ariwodo | Nurse Practitioner | 225 Rue La France, Lafayette, LA 70508-1565 | 2020-06-19 |
| 1578183208 | Donald Glyn Gardner II | Nurse Practitioner | 324 Blue Fox Cir, Haughton, LA 71037-7707 | 2020-04-22 |
| 1629604129 | Raelyn Marie Plauche | Nurse Practitioner | 1951 Florida Ave Sw Ste D&e, Denham Springs, LA 70726-4947 | 2020-03-16 |
| 1962035964 | Tyler Trenton Wansley | Nurse Practitioner | 23515 Us-190, Mandeville, LA 70448 | 2020-02-18 |
| 1114558715 | Danielle J Threatts Aprn LLC | Nurse Practitioner | 208 W Gloria Switch Rd Ste 219, Lafayette, LA 70507-3409 | 2020-02-01 |
| 1992359848 | Harold G Frizzell Psychiatric Services LLC | Nurse Practitioner | 300 Thompson Loop, Lafayette, LA 70506-2820 | 2019-07-29 |
| 1598227779 | Candyce Brown | Nurse Practitioner | 333 Dr Michael Debakey Dr Ste 220, Lake Charles, LA 70601-5888 | 2019-04-04 |
| 1659835346 | Cassandra Thomas-jingles Psychiatric Nurse Practitioner, LLC. | Nurse Practitioner | 156 Mcgehee Dr, Baton Rouge, LA 70815-5012 | 2019-01-26 |
| Find all providers with the same taxonomy | ||||
| City | NEW IBERIA |
| Zip Code | 70560 |
Please comment or provide details below to improve the information on EDIE B POURCIAU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.